Vol:.(1234567890)
Digestive Diseases and Sciences (2019) 64:232–240
https://doi.org/10.1007/s10620-018-5304-0
1 3
ORIGINAL ARTICLE
Diferences in Prevalence of Large Polyps Between Hispanic Americans
from Mexican‑ and Non‑Mexican‑Predominant States
Danny J. Avalos
1
· Marc J. Zuckerman
1
· Alok Dwivedi
2
· Christopher Dodoo
2
· Jinendra Satiya
3
· Fernando J. Castro
4
Received: 21 June 2018 / Accepted: 24 September 2018 / Published online: 1 October 2018
© Springer Science+Business Media, LLC, part of Springer Nature 2018
Abstract
Background There have been conficting reports comparing the prevalence of large polyps (>9 mm) between Hispanics and
non-Hispanic whites (NHW). Diferences between Hispanic subpopulations may account for these variations.
Aims We aimed to assess the prevalence of large polyps (>9 mm) in Hispanics from Mexican- and non-Mexican-predominant
states compared with NHW. As secondary outcome, we evaluated results by polyp location.
Methods The 2010 U.S. Census Bureau was used to identify states with a predominantly Mexican Hispanic (West) versus
non-Mexican Hispanic (East) populations. Average-risk colonoscopies in those states from 2001 to 2014 were accessed using
the Clinical Outcomes Research Initiative database. Military and Veteran’s Administration sites were excluded. Hispanics
were compared with NHW in each geographical location using hierarchical logistic regression analysis.
Results A total of 65,138 procedures were included with 33,425 procedures in the West (14.5% Hispanics) and 31,713 pro-
cedures in the East (44.0% Hispanics,). East Hispanics had signifcantly less odds of large polyps, OR 0.74, CI 0.58–0.94,
p = 0.02, while West Hispanics exhibited no diference, OR 0.91, CI 0.76–1.10, p = 0.33, compared with NHW. Eastern
Hispanics had less odds of large distal polyps, OR 0.69, CI 0.52–0.91, p = 0.01, and no diference in proximal polyps com-
pared with NHW. Among Western Hispanics, no diferences were seen in proximal, OR 1.06, CI 0.83–1.35, p = 0.66, or
distal polyps, OR 0.83, CI 0.68–1.02, p = 0.08, compared with NHW.
Conclusion Using NHW as a reference, Hispanics from Mexican-predominant states have a similar prevalence of large pol-
yps, while Hispanics from non-Mexican-predominant states have a lower prevalence. Diferences in Hispanic subpopulations
likely explain previous conficting reports on the prevalence of large polyps in Hispanics and NHW.
Keywords Hispanic Americans · Polyps · Colonoscopy · Prevalence
* Fernando J. Castro
Castrof@ccf.org
Danny J. Avalos
Danny.avalos@ttuhsc.edu
Marc J. Zuckerman
Marc.Zuckerman@ttuhsc.edu
Alok Dwivedi
Alok.dwivedi@ttuhsc.edu
Christopher Dodoo
Christopher.dodoo@ttuhsc.edu
Jinendra Satiya
Jinen19@gmail.com
1
Division of Gastroenterology, Texas Tech University Health
Sciences Center El Paso, El Paso, TX, USA
2
Biostatistics and Epidemiology Consulting Lab, Texas Tech
University Health Sciences Center El Paso, El Paso, TX,
USA
3
University of Miami/JFK GME Consortium, Atlantis, FL,
USA
4
Digestive Disease Center, Department of Gastroenterology,
Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd,
Weston, FL 33331, USA