(HealthDay News) — Age and race/ethnicity are independently associated with the overall risk for colorectal cancer among veterans, according to a study published online May 28 in the Journal of Clinical Gastroenterology.
Thomas F. Imperiale, M.D., from Indiana University in Indianapolis, and colleagues assessed the effects of age, sex and race/ethnicity on the risk for colorectal cancer and advanced neoplasia among veterans. The analysis included 90,598 veterans (aged 40 to 80 years) who had diagnostic or screening colonoscopy between 2002 and 2009 at one of 14 Veterans Affairs medical centers.
The researchers found that colorectal cancer prevalence was 1.3% and advanced neoplasia prevalence was 8.9%. For diagnostic colonoscopy, the adjusted colorectal cancer risk was higher than for screening colonoscopy (odds ratio [OR], 3.79; 95% confidence interval [CI], 3.19 to 4.50). CRC risk increased with age and was higher, but not statistically, for men overall (OR, 1.53; 95% CI, 0.97 to 2.39) in the diagnostic colonoscopy group and in the screening subgroup (OR, 2.24; 95% CI, 0.71 to 7.05). Additionally, colorectal cancer risk was higher overall for Blacks and Hispanics, but not in screening. Advanced neoplasia prevalence was 9.2% in men and 3.9% in women (adjusted OR, 1.90; 95% CI, 1.60 to 2.25), and the prevalence increased with age. Advanced neoplasia risk was higher in Blacks versus whites overall (OR, 1.11; 95% CI, 1.04 to 1.20) and was lower in Hispanics (OR, 0.74; 95% CI, 0.55 to 0.98). Proximal colorectal cancer was more common in women than men, but there was no difference between the genders for proximal advanced neoplasia.
“A risk-based model that includes age, gender, and perhaps other features such as cigarette smoking and physical measures may be useful for both tailoring colorectal cancer screening and optimizing resource allocation within the Veterans Health Administration and in other health care systems,” the authors write.
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