Impact of type 2 diabetes on adenoma detection in screening colonoscopies performed in disparate populations
Autor: | Dimitri Joseph, Evan Grossman, Yi-Cong Zhu, Jonathan M. Buscaglia, Juan Carlos Bucobo, Samuel L. Stanley, Rajesh Veluvolu, Joshua D. Miller, Jie Yang, Michele Follen, Lorenzo F. Ottaviano, Xiao-Ning Li, Ellen Li |
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Rok vydání: | 2021 |
Předmět: |
Adenoma
medicine.medical_specialty Multivariate analysis endocrine system diseases education Colonoscopy Type 2 diabetes 03 medical and health sciences fluids and secretions 0302 clinical medicine Internal medicine African continental ancestry group parasitic diseases medicine Retrospective Cohort Study medicine.diagnostic_test business.industry Diabetes mellitus type 2 General Medicine medicine.disease body regions 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology business European continental ancestry group |
Zdroj: | World Journal of Clinical Cases |
ISSN: | 2307-8960 |
Popis: | BACKGROUND The Black/African Ancestry (AA) population has a higher prevalence of type 2 diabetes mellitus (T2DM) and a higher incidence and mortality rate for colorectal cancer (CRC) than all other races in the United States. T2DM has been shown to increase adenoma risk in predominantly white/European ancestry (EA) populations, but the effect of T2DM on adenoma risk in Black/AA individuals is less clear. We hypothesize that T2DM has a significant effect on adenoma risk in a predominantly Black/AA population. AIM To investigate the effect of T2DM and race on the adenoma detection rate (ADR) in screening colonoscopies in two disparate populations. METHODS A retrospective cohort study was conducted on ADR during index screening colonoscopies (age 45-75) performed at an urban public hospital serving a predominantly Black/AA population (92%) (2017-2018, n = 1606). Clinical metadata collected included basic demographics, insurance, body mass index (BMI), family history of CRC, smoking, diabetes diagnosis, and aspirin use. This dataset was combined with a recently reported parallel retrospective cohort data set collected at a suburban university hospital serving a predominantly White/EA population (87%) (2012-2015, n = 2882). RESULTS The ADR was higher in T2DM patients than in patients without T2DM or prediabetes (35.2% vs 27.9%, P = 0.0166, n = 981) at the urban public hospital. Multivariable analysis of the combined datasets showed that T2DM [odds ratio (OR) = 1.29, 95% confidence interval (CI): 1.08-1.55, P = 0.0049], smoking (current vs never OR = 1.47, 95%CI: 1.18-1.82, current vs past OR = 1.32, 95%CI: 1.02-1.70, P = 0.0026), older age (OR = 1.05 per year, 95%CI: 1.04-1.06, P < 0.0001), higher BMI (OR = 1.02 per unit, 95%CI: 1.01-1.03, P = 0.0003), and male sex (OR = 1.87, 95%CI: 1.62-2.15, P < 0.0001) were associated with increased ADR in the combined datasets, but race, aspirin use and insurance were not. CONCLUSION T2DM, but not race, is significantly associated with increased ADR on index screening colonoscopy while controlling for other factors. |
Databáze: | OpenAIRE |
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