Retrospective Study
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2014; 20(26): 8606-8611
Published online Jul 14, 2014. doi: 10.3748/wjg.v20.i26.8606
Birthplace is not a determinant of colorectal adenomas
Fiona Tran, Jenn Hian Koo
Fiona Tran, Jenn Hian Koo, Department of Gastroenterology and Hepatology, Liverpool Hospital, NSW 1871, Australia
Fiona Tran, Jenn Hian Koo, Department of Gastroenterology, The University of New South Wales, NSW 2052, Australia
Author contributions: Tran F was involved in study concept and design, acquisition of data, analysis and interpretation of data and drafting and critical revision of the manuscript; Koo JH was involved in study concept and design, analysis and interpretation of data, critical revision of the manuscript and final approval of article.
Correspondence to: Fiona Tran, MBBS, Department of Gastroenterology and Hepatology, Liverpool Hospital, Sydney South West Local Health District, Locked Mailbag 7103, Liverpool, NSW 1871, Australia. f.tran88@gmail.com
Telephone: +61-8738-4085 Fax: +61-8738-3094
Received: November 25, 2013
Revised: February 10, 2014
Accepted: April 21, 2014
Published online: July 14, 2014
Abstract

AIM: To examine the impact of the patient’s birthplace on the prevalence of colonic polyps and histopathological subtypes.

METHODS: This is a retrospective audit of the colonoscopy practice of one Gastroenterologist in a tertiary-referral hospital from 2008 to 2011. Data collected include demography, birthplace, language spoken, details of the colonoscopy including indications, completion rates, complications, results including prevalence and histopathology of polyps. Statistical methods used were binary logistic regression, χ2 and Mann-Whitney U.

RESULTS: A total of 623 patients (48% male, 67% aged over 50 years) were recruited and categorised according to birthplace: Australia/New Zealand 42%, European 20%, Asian 15%, Middle Eastern/African 11%, South American 9% and Pacific Islander 3%. The median age of the cohort was 56.3 years (range: 17-91 years), median body mass index 27.3 kg/m2 (range: 16-51 kg/m2), 25% were smokers, 25% had hypercholesterolemia, 20% had diabetes mellitus 16% were on aspirin and 7% were on non-steroidal anti-inflammatory drugs. A total of 651 colonoscopies were performed for standard indications. The prevalence of polyps varied according to patient’s birthplace: Europe 45.1%, Australia and New Zealand 39.5%, Pacific Islands 33.3%, Asia 30.3%, Middle East and Africa 26.9% and South America 24.5% (P = 0.027, df = 6). However, multivariate analysis revealed that birthplace was not an independent predictor of developing polyps, including adenomas and advanced adenomas after correcting for age and male sex.

CONCLUSION: Birthplace is not a predictor for developing colorectal neoplasia, including adenomas and advanced adenomas; hence, should not influence the recommendations for colorectal cancer screening.

Keywords: Ethnicity, Polyps, Adenomas, Advanced adenomas, Colorectal cancer

Core tip: The detection and removal of colorectal adenomas is a vital component of colorectal cancer prevention. The provision of colorectal cancer screening by medical practitioners is influenced by patient’s ethnicity. However, birthplace is not a predictor for developing colorectal neoplasia, including polyps, adenomas and advanced adenomas; hence, should not influence the recommendations for colorectal cancer screening.