Prevalence of adenomas and sessile serrated adenomas in C hinese compared with C aucasians

Background and Aims Colonic adenomas and sessile serrated adenomas ( SSA ) are the most common premalignant polyps identified at colonoscopy. This study compares the prevalence of neoplastic polyps in C hinese and C aucasians in a general gastroenterology outpatient practice in A ustralia. Methods This study included consecutive unselected colonoscopies performed for standard clinical indications by a single endoscopist ( JMH ). All polyps detected were measured, resected, and sent for histopathology. The prevalence of adenomas, advanced adenomas, SSA , and cancer in the C hinese and C aucasian cohorts were compared. Advanced adenomas were defined as adenomas > 10 mm, villous histology, or high‐grade dysplasia. Results The study included 346 C hinese and 654 C aucasians. There was no significant difference in the baseline characteristics including age, gender, and indications of colonoscopy, although C hinese were more likely to present with rectal bleeding (22.8% vs 15.9%, P  = 0.01). The prevalence of adenomatous polyps was similar in both C aucasians (34.3%) and C hinese (35.3%). However, advanced adenomas were more significantly common in C aucasians (11.3%) compared with C hinese (4.6%) ( P  < 0.001). SSA was rare in C hinese (2%) but present more frequently in C aucasians (7%) ( P  = 0.001). Multivariate analysis showed that C aucasian ethnicity (odds ratio 2.4, 95% confidence interval 1.6–3.6) and the presence of SSA (odds ratio 4.4, 95% confidence interval 2.3–8.6) were independent predictors for the detection of an advanced adenoma. Conclusions The prevalence of significant colorectal lesions, including advanced adenomas, large adenomas, and SSA , were lower in C hinese compared with C aucasians. These findings may influence the guidelines for colonic cancer screening in C hinese populations.