P098 HISPANICS WITH INFLAMMATORY BOWEL DISEASE HAVE A LOWER PREVALENCE OF COLONIC DYSPLASIA COMPARED TO NON-HISPANIC WHITES: RESULTS OF A LARGE TERTIARY REFERRAL COHORT. (7th February 2019)

• Record Type: Journal Article
• Authors: Damas, Oriana; Estes, Derek; Raffa, Gabriella; Quintero, Alejandra; Deshpande, Amar; Kerman, David; Abreu, Maria
• Is Part Of: Inflammatory bowel diseases. Volume 25(2019)Supplement 1
• Page Start: S46
• Page End: S47
• Publication Date: 2019-02-07
• Subjects: Inflammatory bowel diseases -- Periodicals; Colitis, Ulcerative -- Periodicals; Crohn Disease -- Periodicals; Inflammatory Bowel Diseases -- Periodicals; 616.344
• DOI: 10.1093/ibd/izy393.106
• Languages: English
• ISSNs: 1078-0998

Abstract

Abstract: Introduction: Disease burden for colorectal cancer varies considerably by ethnicity. US Hispanics have a high colorectal adenoma burden but a lower incidence of colon cancer compared to non-Hispanic whites (NHW). Although the incidence of IBD in US Hispanics is rising, data is lacking on the prevalence of IBD-associated dysplasia within Hispanics. The aims of this study were to examine 1) differences in prevalence of colon dysplasia between Hispanics and NHW 2) differences in risk factors for dysplasia between Hispanics and NHW. Methods: This was a retrospective cohort of adult IBD patients followed at a tertiary referral IBD center between 2010-2018. Ethnicity was self-identified. Demographic and clinical history was obtained from the IBD database. Colonoscopy frequency, use of chromoendoscopy and endoscopic/histologic details of dysplasia were recorded. Appropriate surveillance was defined as a colonoscopy within 3 years of the prior, in patients who met criteria for surveillance (e.g. pancolitis for ≥8 yrs or left sided colitis for ≥15 yrs.). Endoscopic/histologic reports were reviewed in patients with dysplasia, when available. Data was analyzed using Stata v.15. We performed Chi-square and Wilcoxon-Mann-Whitney test for non-normal distributions. Binary logistic regression was used to evaluate for differences in presence of dysplasia between Hispanics and NHW, taking into account significant co-variables. Results: A total of 1848 patients were included: 730 Hispanics and 1118 NHW. Of these, a total of 54 patients had colon dysplasia (15 (2.1%) Hispanics and 43 (3.8%) non-Hispanics, p =.002). Hispanics developed IBD at an older age, had a shorter disease duration and had a lower prevalence of IBD family history, compared to NHW (Table 1). Hispanics and NHW had appropriate surveillance colonoscopies and use of chromoendoscopy. In a multivariable logistic regression model, NHW were 2.4x more likely to develop dysplasia than Hispanics, despite accounting for age at IBD diagnosis, duration of disease, and presence of pancolitis (Beta=.90, p (ethnicity)=.02). In this preliminary analysis of histology, Hispanics have a higher prevalence of sporadic adenomas and a lower prevalence of IBD-associated dysplasia than NHW. In patients developing IBD-associated dysplasia, there was no difference between Hispanics and NHW in presence of high or low-grade dysplasia (Table 2). There was no difference in time from diagnosis to development of dysplasia between Hispanics and NHW. Conclusions: This is the first study to describe the prevalence of colon dysplasia in Hispanics with IBD. In this ongoing study, Hispanics have a lower prevalence of colon dysplasia than NHW despite similar known risk factors and surveillance intervals. Future studies should identify environmental or diet-related exposures that may protect against dysplasia in this population.