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Ethnic variation in colorectal cancer risk following a positive faecal occult blood test in an English bowel cancer screening programme centre

Padmanabhan, Haria; Widlak, Monikaa; Nevill, Alanb; McKaig, Briana; Brookes, Matthewa; Veitch, Andrewa

European Journal of Gastroenterology & Hepatology: November 2015 - Volume 27 - Issue 11 - p 1281–1285
doi: 10.1097/MEG.0000000000000443
Original Articles: Colorectal Cancer

Background and aims The literature on colorectal cancer (CRC) screening and ethnic diversity is dominated by studies from the USA. There are no such published data from the UK bowel cancer screening programme (BCSP) population. The Wolverhampton Bowel Cancer Screening Centre serves a population of 900 000 in the Black Country and South Staffordshire. South Asians (SA) comprise 9% of the population. We aimed to determine the effects of ethnicity and sex on the risk for cancer or adenoma detected by colonoscopy following a positive faecal occult blood test over a 5-year period (2007–2011).

Methods Data were collected from the prospectively maintained BCSP cohort. South Asian patients were identified and compared with those of non-South Asian ethnicity, and colonoscopy outcomes were determined.

Results A total of 3552 participants underwent BCSP colonoscopy (non-South Asian=3363; SA=189). There were 271 cancers (7.6%) detected within the non-South Asian group and seven cancers (0.2%) in the South Asian population (P<0.05). The probability of colon cancer is higher [odds ratio (OR)=3.84, P<0.05] in non-South Asians compared with South Asians. Patients in the 65–70-year age group have the highest risk (OR=1.60; P<0.05) for CRC. During the study 1313 adenomas were detected. A total of 771 high-risk and intermediate-risk adenomas were detected in the non-South Asian group, and 14 were detected in the South Asian group. The risk of adenoma in non-South Asians is six times higher than in South Asians (OR=5.99, P<0.001) following positive faecal occult blood testing.

Conclusion There are fewer colorectal cancers in South Asians compared with the non-South Asian population in this regional study. This is the first such study in the BCSP population.

aDepartment of Gastroenterology, Royal Wolverhampton Hospitals NHS Trust

bResearch Institute of Healthcare Sciences, University of Wolverhampton, Wolverhampton, UK

Presented at UEG Week Vienna 2014, 18–22 October 2014.

Correspondence to Hari Padmanabhan, Department of Gastroenterology, Royal Wolverhampton NHS Trust, Wolverhampton WV10 0QP, UK Tel: +44 1902 694112; fax: +44 1902 695738; e-mail:

Received March 16, 2015

Accepted June 29, 2015

Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.