PMID- 25835747 OWN - NLM STAT- MEDLINE DCOM- 20160701 LR - 20221207 IS - 1525-1497 (Electronic) IS - 0884-8734 (Print) IS - 0884-8734 (Linking) VI - 30 IP - 10 DP - 2015 Oct TI - Occurrence of Distal Colorectal Neoplasia Among Whites and Blacks Following Negative Flexible Sigmoidoscopy: An Analysis of PLCO Trial. PG - 1447-53 LID - 10.1007/s11606-015-3297-3 [doi] AB - BACKGROUND: It is unclear whether the higher rate of colorectal cancer (CRC) among non-Hispanic blacks (blacks) is due to lower rates of CRC screening or greater biologic risk. OBJECTIVE: We aimed to evaluate whether blacks are more likely than non-Hispanic whites (whites) to develop distal colon neoplasia (adenoma and/or cancer) after negative flexible sigmoidoscopy (FSG). DESIGN: We analyzed data of participants with negative FSGs at baseline in the Prostate, Lung, Colorectal, and Ovarian (PLCO) cancer screening trial who underwent repeat FSGs 3 or 5 years later. Subjects with polyps or masses were referred to their physicians for diagnostic colonoscopy. We collected and reviewed the records of diagnostic evaluations. PARTICIPANTS: Our analytic cohort consisted of 21,550 whites and 975 blacks. MAIN MEASURES: We did a comparison by race (whites vs. blacks) in the findings of polyps or masses at repeat FSG, the follow-up of abnormal test results and the detection of colorectal neoplasia at diagnostic colonoscopy. KEY RESULTS: At the follow-up FSG examination, 304 blacks (31.2 %) and 4183 whites (19.4 %) had abnormal FSG, [adjusted relative risk (RR) = 1.00; 95 % confidence interval (CI), 0.90-1.10]. However, blacks were less likely to undergo diagnostic colonoscopy (76.6 % vs. 83.1 %; RR = 0.90; 95 % CI, 0.84-0.96). Among all included patients, blacks had similar risk of any distal adenoma (RR = 0.86; 95 % CI, 0.65-1.14) and distal advanced adenoma (RR = 1.01; 95 % CI, 0.60-1.68). Similar results were obtained when we restricted our analysis to compliant subjects who underwent diagnostic colonoscopy (RR = 1.01; 95 % CI, 0.80-1.29) for any distal adenoma and (RR = 1.18; 95 % CI, 0.73-1.92) for distal advanced adenoma. CONCLUSIONS: We did not find any differences between blacks and whites in the risk of distal colorectal adenoma 3-5 years after negative FSG. However, follow-up evaluations were lower among blacks. FAU - Laiyemo, Adeyinka O AU - Laiyemo AO AD - Department of Medicine, Howard University College of Medicine, Washington, DC, USA. adeyinka.laiyemo@howard.edu. AD - Biometry Research Group, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. adeyinka.laiyemo@howard.edu. AD - Division of Gastroenterology, Department of Medicine, Howard University College of Medicine, 2041 Georgia Avenue, NW, Washington, DC, 20060, USA. adeyinka.laiyemo@howard.edu. FAU - Doubeni, Chyke AU - Doubeni C AD - Department of Family Medicine and Community Health at the Perelman School of Medicine, Leonard Davis Institute for Health Economics, and the Center for Public Health Initiatives, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. FAU - Pinsky, Paul F AU - Pinsky PF AD - Early Detection Research Group, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. FAU - Doria-Rose, V Paul AU - Doria-Rose VP AD - Health Services and Economics Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. FAU - Bresalier, Robert AU - Bresalier R AD - M.D. Anderson Cancer Center, Houston, TX, USA. FAU - Hickey, Thomas AU - Hickey T AD - Information Management Services Inc., Rockville, MD, USA. FAU - Riley, Thomas AU - Riley T AD - Information Management Services Inc., Rockville, MD, USA. FAU - Church, Tim R AU - Church TR AD - Department of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA. FAU - Weissfeld, Joel AU - Weissfeld J AD - Department of Medicine and Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA. FAU - Schoen, Robert E AU - Schoen RE AD - Department of Medicine and Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA. FAU - Marcus, Pamela M AU - Marcus PM AD - Health Services and Economics Branch, Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. FAU - Prorok, Philip C AU - Prorok PC AD - Biometry Research Group, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. LA - eng GR - U01CA151736/CA/NCI NIH HHS/United States GR - KL2 TR000102/TR/NCATS NIH HHS/United States GR - KL2TR000102/TR/NCATS NIH HHS/United States GR - KL2 TR001432/TR/NCATS NIH HHS/United States GR - K01 CA127118/CA/NCI NIH HHS/United States GR - R21 DK100875/DK/NIDDK NIH HHS/United States GR - 5K01CA127118/CA/NCI NIH HHS/United States GR - UL1RT000101/PHS HHS/United States GR - R21DK100875/DK/NIDDK NIH HHS/United States GR - U01 CA151736/CA/NCI NIH HHS/United States PT - Journal Article PT - Multicenter Study PT - Randomized Controlled Trial PT - Research Support, N.I.H., Extramural DEP - 20150403 PL - United States TA - J Gen Intern Med JT - Journal of general internal medicine JID - 8605834 SB - IM MH - Aged MH - Black People/*ethnology MH - Cohort Studies MH - Colorectal Neoplasms/diagnosis/*ethnology MH - Early Detection of Cancer/*methods/trends MH - Female MH - Follow-Up Studies MH - Humans MH - Lung Neoplasms/diagnosis/ethnology MH - Male MH - Middle Aged MH - Neoplasms MH - Ovarian Neoplasms/diagnosis/ethnology MH - Prospective Studies MH - Prostatic Neoplasms/diagnosis/ethnology MH - Sigmoidoscopy/*methods/trends MH - White People/*ethnology PMC - PMC4579215 OTO - NOTNLM OT - PLCO OT - adenomatous polyps OT - colorectal cancer disparities OT - flexible sigmoidoscopy OT - screening EDAT- 2015/04/04 06:00 MHDA- 2016/07/02 06:00 PMCR- 2016/10/01 CRDT- 2015/04/04 06:00 PHST- 2014/04/19 00:00 [received] PHST- 2015/03/13 00:00 [accepted] PHST- 2014/11/17 00:00 [revised] PHST- 2015/04/04 06:00 [entrez] PHST- 2015/04/04 06:00 [pubmed] PHST- 2016/07/02 06:00 [medline] PHST- 2016/10/01 00:00 [pmc-release] AID - 10.1007/s11606-015-3297-3 [pii] AID - 3297 [pii] AID - 10.1007/s11606-015-3297-3 [doi] PST - ppublish SO - J Gen Intern Med. 2015 Oct;30(10):1447-53. doi: 10.1007/s11606-015-3297-3. Epub 2015 Apr 3.