Clinical Investigation| Volume 364, ISSUE 4, P394-403, October 2022

Colorectal neoplasia prevalence in a predominantly Hispanic community: Results from a colorectal cancer screening program in Texas



      A community-based, colorectal cancer (CRC) screening program for uninsured/underinsured individuals was successfully implemented in El Paso, Texas to increase CRC screening rates. Our aim was to determine the colorectal neoplasia prevalence among program participants and between screening groups.


      We retrospectively reviewed participant records from 2012 to 2017. Average-risk patients were first screened with a fecal immunochemical test (FIT) and included if positive. Above average-risk patients due to a family history of CRC were referred directly for screening colonoscopy. Patients were excluded if experiencing melena or hematochezia or had a personal history of colon polyps or CRC.


      Of the 638 screening colonoscopies performed, 59.4% were in FIT-positive subjects and 40.6% were in subjects with a family history of CRC. Patients were predominantly female (72.9%), aged 50-65 years (84.2%), Hispanic (97.9%), and born in Mexico (92.4%). Overall, the detection rate for polyps, adenomas, and advanced adenomas was 46.2%, 34.3%, and 11.1%, respectively. Fifteen patients had adenocarcinoma (2.4%). Compared with colonoscopies in patients with a family history, FIT-positive patients demonstrated a higher prevalence of polyps (PR 1.39, 95% CI 1.09-1.78), adenomas (PR 1.55, 95% CI 1.15-2.07), advanced adenomas (PR 3.04, 95% CI 1.67-5.56).


      This community-based CRC screening program in an enriched cohort of predominantly Mexican Americans was effective in identifying colorectal neoplasia and cancer. Additionally, there was an increased prevalence of colorectal neoplasia in average-risk, FIT-positive patients undergoing screening colonoscopy compared with above average-risk patients with a family history of CRC. Similar screening programs would likely benefit at-risk populations.

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      • Colon cancer screening is for everyone
        The American Journal of the Medical SciencesVol. 364Issue 4
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          Colorectal cancer is the fourth most common new cancer diagnosis (excluding skin) in the United States with lifetime incidence rates of approximately 4%.1 With the recognition that cancers and large polyps may cause occult gastrointestinal bleeding, randomized trials in the early 1990s demonstrated that screening by fecal occult blood testing reduced colorectal cancer mortality.2 Subsequent investigations demonstrated that screening flexible sigmoidoscopy reduced both colorectal cancer incidence and mortality.
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