While Inflammatory Bowel Disease (IBD) is well described in the non-Hispanic white (NHW) population, it is poorly characterized in Hispanics. In fact, little data exists on the prevalence of colon cancer and dysplasia in Hispanics in the setting of IBD. Prior studies suggest that the prevalence of non-IBD colon cancer is lower in Hispanics than in NHW. Our aim was to identify the prevalence of dysplasia in our Hispanic IBD population compared to NHWs with IBD and to identify differences in risk factors and endoscopic features of their dysplasia.Methods:
This was a retrospective cohort of adult IBD patients followed in a tertiary referral GI clinic or in a safety-net hospital GI clinic between 2010 and 2015. Ethnicity was self-identified and only self-identified Hispanics and non-Hispanic whites were included. We queried from the electronic medical record and IBD research intake form for a history of colonic dysplasia. Demographics including smoking, family history of IBD, family history of colon cancer was collected. Patient's IBD history and dysplasia history (including period of surveillance colonoscopies, pathology findings and endoscopic characteristics) was collected. Data was analyzed using Chi-square and ANOVA where appropriate.Results:
A total of 1652 patients were identified: 6 out of 690 Hispanics had dysplasia (0.87%), and 26 out of 962 NHW had dysplasia (2.7%). Among patients with dysplasia, 18.75% were Hispanic and 81.25% were NHW. Among patients with dysplasia, Hispanics had mainly Crohn's disease (66.7%) and NHWs had mainly ulcerative colitis (57.7%). There was no significant difference between Hispanics and NHW in family history of IBD, family history of colon cancer, and patient history of Primary Sclerosing Cholangitis. The Hispanic group presented with symptoms at an earlier age than NHWs (M = 25.67, SD = 11.50 versus M = 33.85, SD = 18.93), though findings were not significant (F(1,30) = 1.02, P = 0.32). There was no difference in mean duration of disease between Hispanics and NHWs (M = 30.00, SD = 19.84 versus M = 28.83, SD = 15.44, F(1,30) = 0.03, P = 0.85). There was no significant difference between Hispanics and NHW in IBD location of disease (e.g., pancolitis, proctitis). Endoscopic features were similar between Hispanics and NHW, these included: presence of surrounding inflammation, flat versus visible dysplasia, presence of pseudopolyps, endoscopically-resectable dysplasia, and high versus low grade dysplasia; need for surgery after dysplasia was also not different between groups.Conclusions:
Preliminary results of our ongoing study demonstrate that although the prevalence of dysplasia is different between Hispanics and NHW, there are no differences in the presence of known risk factors for dysplasia or in endoscopic/histologic characteristics. Future studies evaluating ethnic differences in genetic predisposition to IBD-associated colon cancer are warranted.