PWE-003 Variations in Adenoma Detection Rate and Cancer Detection Rate in Individuals from Different Ethnic Groups Undergoing Bowel Cancer Screening Colonoscopy

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Abstract

Introduction

The prevalent round of the Bowel Cancer Screening Programme (BCSP) in England commenced in August 2006. Analysis of the first three years of the BCSP reveals a mean adenoma detection rate (ADR) of 46.5% (range 21.9-59.8%), and a mean polyp detection rate (PDR) of 59.7% (range 39.8–76.3%).1

Introduction

Anecdotally, BCSP colonoscopists have suggested that the PDR, ADR and cancer detection rates in screened individuals of South Asian descent may be lower than those of Caucasian (white) descent. This has never been proven as the BCSP does not record ethnic origin of screened individuals.

Methods

Between May 1st and December 31st 2013, every screened individual in Leicester and Kettering had their self-selected ethnic origin recorded in a database. The endoscopic findings and histology results noted in the Exeter online database was correlated to the database containing ethnic origin data and analysed.

Results

851 screened individuals (colonoscopy), 466 individuals had polyps (394 adenomas), PDR = 54.76%, ADR = 46.30%, cancer detection rate = 5.41%.

Results

734 “White” individuals (86.25%)

Results

45 individuals had cancer (cancer detection rate = 6.13%)

Results

421 individuals had polyps, PDR = 57.36% (95% CI: 53.75–60.89%)

Results

353 individuals had polyps, ADR = 48.09% (95% CI: 44.50–51.71%)

Results

101 “Asian or Asian British” (11.87%)

Results

1 individual had cancer (cancer detection rate = 0.99%)

Results

36 individuals had polyps, PDR = 35.64% (95% CI: 26.99–45.35%)

Results

32 individuals had polyps, ADR = 31.68% (95% CI: 23.42–41.29%)

Results

16 “Mixed”, “Black or Black British” or “Other Ethnic Groups” (1.88%)

Results

0 cancers, 8 individuals with polyps/adenomas (PDR/ADR = 50%)

Results

Too few to meaningfully analyse

Conclusion

This analysis reveals a statistically significant lower ADR and PDR for South Asian screened individuals when compared to Caucasian (White) individuals. There is also a strong trend showing a lower cancer detection rate. This is important for clinicians to be aware of so that they can fully inform individuals undergoing colonoscopic screening.

Conclusion

For regions with large South Asian populations, this observation can be used to appropriately plan services. ADR and cancer detection rates in these regions may be lower and may be a factor in the regional variations of ADR and cancer detection across the BCSP.

Disclosure of Interest

None Declared.

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