Variation of adenoma prevalence influences screening and quality programs

This month's issue of the Clinical Gastroenterology & Hepatology investigates the variation of adenoma prevalence by age, sex, race, and colon location, and implications for screening.

Reliable community-based colorectal adenoma prevalence estimates are needed to inform colonoscopy quality standards and to estimate patient colorectal cancer risks.

However, minimal data exist from populations with large numbers of diverse patients and examiners.

Dr Douglas Corley and colleagues evaluated the prevalence of adenomas detected by sex, age, race/ethnicity, and colon location among 20,792 Kaiser Permanente Northern California members years of age who received a screening colonoscopy exam.

The team reported that the prevalence of detected adenomas increased more rapidly with age in the proximal colon than in the distal colon.

Prevalence was higher among men vs women at all ages, increasing in men from 25% to 39% at 70 years, and in women from 15% at 50-54 years to 26% .

Prevalence increased in men from 25% to 39% at 70 years

Clinical Gastroenterology & Hepatology

The research team noted that proximal adenoma prevalence was higher among blacks than whites, although total prevalence was similar, including for persons 60 years old.

Dr Corley's team commented, "Prevalence of detected adenomas increases substantially with age and is much higher in men."

"Proximal adenomas are more common among blacks than whites, although the total prevalence and the prevalence for agesvalid, without adjustment, for comparing providers serving different populations."

"The variation in prevalence and location may also have implications for the effectiveness of screening methods in different demographic groups."