Original articleAlimentary tractVariation of Adenoma Prevalence by Age, Sex, Race, and Colon Location in a Large Population: Implications for Screening and Quality Programs
Section snippets
Setting
This is a retrospective cohort study among members of Kaiser Permanente Northern California, an integrated health services delivery organization that serves approximately 3.3 million people across 15 medical centers in urban, suburban, and semirural regions within a large geographic area. Its membership demographics closely approximate the diverse underlying population of Northern California, as compared with census demographics, including members with Medicare, Medicaid (low-income), and
Results
Between January 2006 and December 2008, we identified 20,792 screening colonoscopies among 125,462 total colonoscopy examinations performed for any indication for members ≥50 years of age. Examinations were excluded for the following reasons: diagnostic or surveillance examination indications (including history of an adenoma) (n = 73,922); colonoscopy within the previous 10 years, sigmoidoscopy within the previous 5 years, or a positive stool blood test within the previous year (n = 28,890);
Discussion
The success of colorectal cancer screening programs largely depends on the identification and removal of precancerous adenomas and early-stage cancers amenable to treatment. Prior publications have evaluated differences in colorectal cancer incidence by sex, age, and race/ethnicity; however, this article reports the detailed prevalence of detected colorectal adenomas at screening colonoscopy by patient demographics within a large multimedical center, community-based population with
References (41)
- et al.
How many endoscopies are performed for colorectal cancer screening? Results from CDC's survey of endoscopic capacity
Gastroenterology
(2004) - et al.
Adenoma detection rate increases with each decade of life after 50 years of age
Gastrointest Endosc
(2011) - et al.
Polyp size and advanced histology in patients undergoing colonoscopy screening: implications for CT colonography
Gastroenterology
(2008) - et al.
Can we improve adenoma detection rates? A systematic review of intervention studies
Gastrointest Endosc
(2011) - et al.
Effect of screening colonoscopy on colorectal cancer incidence and mortality
Clin Gastroenterol Hepatol
(2009) - et al.
Screening colonoscopy in asymptomatic average-risk African Americans
Gastrointest Endosc
(2000) - et al.
Cancer statistics, 2009
CA Cancer J Clin
(2009) - et al.
Annual report to the nation on the status of cancer, 1975–2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates
Cancer
(2010) - et al.
Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology
CA Cancer J Clin
(2008) - et al.
Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths
N Engl J Med
(2012)
Quality indicators for colonoscopy
Am J Gastroenterol
Adenoma detection rate and the quality of colonoscopy: the sword has two edges
Dis Colon Rectum
Quality indicators for colonoscopy and the risk of interval cancer
N Engl J Med
Population-based Research Optimizing Screening through Personalized Regimens (PROSPR)
Colorectal cancer risk: black, white, or shades of gray?
JAMA
Racial clustering and access to colorectal surgeons, gastroenterologists, and radiation oncologists by African Americans and Asian Americans in the United States: a county-level data analysis
Arch Surg
Use of colonoscopy to screen asymptomatic adults for colorectal cancer: Veterans Affairs Cooperative Study Group 380
N Engl J Med
The prevalence rate and anatomic location of colorectal adenoma and cancer detected by colonoscopy in average-risk individuals aged 40-80 years
Am J Gastroenterol
Prevalence of colon polyps detected by colonoscopy screening in asymptomatic black and white patients
JAMA
Prevalence of colon polyps detected by colonoscopy screening of asymptomatic Hispanic patients
Dig Dis Sci
Cited by (0)
Conflicts of interest The authors disclose no conflicts.
Funding Supported by grants from the Kaiser Permanente Community Benefits program and from the National Cancer Institute (U54 CA163262).