Heba Habbal, MD1, Hajra Khan, MD2, Salina Faidhalla, MD2, Eskara Pervez, MD2, Anshu Wadehra, MD2, Mahvish Khalid, MD2, Hamid-Reza Moein, MD2, Enofe Ikponmwosa, MD3, Diana Kakos, MS4, Paul Naylor, PhD5, Bashar Mohamad, MD6; 1Oakwood Hospital and Medical Center, Dearborn, MI; 2Wayne State University, Detroit Medical Center, Detroit, MI; 3Michigan State University, Lansing, MI; 4Wayne State University, School of Medicine, Detroit, MI; 5WSU, Detroit, MI; 6WSUPG, Detroit, MI
Introduction: Increased body mass index (BMI) is a recognized risk factor for the development of colo-rectal cancer (CRC). Although the incidence of adenoma clearly correlates with risk of CRC, the relationship between the presence of adenomas and BMI has not been consistently demonstrated among all populations especially African Americans (AA). The objective of this study was to evaluate the correlation between adenomas and BMI in AA as compared to Non-AA. Methods: From a database of 1010 patients undergoing screening or surveillance colonoscopy in the last 6 months of 2017, we identified 729 patients whose colonoscopy was performed only by academic gastroenterologists (GI). There were 648 AA (89%) and 81 non-AA in the study with an average age of 58 and similar gender (54% female). The BMI (kg/m2) was slightly higher in females as compared to males (31.7+/-0.3 vs 28.9+/-0.38 p<0.001) but was not different by race (30.5 vs 29.6). BMI was evaluated both as a continuous variable and categorical using the standard definitions (normal <25, overweight (25-30) and obese (<30)) Results: There were 244 individuals with adenomas in the 574 screening colonoscopies (43%) and 79 in the 135 surveillance colonoscopies (59%) (p<0.001). When comparing Non-AA patients to AA patients using Logistic Fit models, Non-AA patients had an increase in adenomas detected with the increase in BMI (p<0.016). In contrast, AA had a decrease in individuals found to have adenomas with the increase in BMI (p= 0.22 Probability>ChiSq) (Figure 1). The increase in individuals with adenomas was more likely to be in the male AA as compared to the females. In non-AA patients, both males and females were more likely to have an adenoma with the increase in BMI. Similar observations were made for both surveillance and screening colonoscopies. When patient BMI was categorized as normal, overweight, or obese, the relationship was similar (Figure 2). Discussion: Unlike in non-AA individuals, an increase in BMI in AA individuals does not correlate with the detection of adenoma’s on colonoscopy. In contrast to most of the literature, this study reduces the role of variation in endoscopists by using the high adenoma detection rate academic GI physicians and a homogeneous population with respect to gender and age. The reason that BMI does not correlate with the detection of adenomas in AA patients is not known.
Figure 1 Correlation between BMI and Presence of Adenoma by Race. Non-AA had an increase in Adenomas with increase in BMI whereas AA individuals had a decline.
Figure 2 Correlation between BMI category (normal, overweight or obese) and the Presence of Adenoma by Race. In contrast to Non-AA individuals, AA did not have an increase in Adenomas Detection Rate with increasing BMI.
Disclosures: Heba Habbal indicated no relevant financial relationships. Hajra Khan indicated no relevant financial relationships. Salina Faidhalla indicated no relevant financial relationships. Eskara Pervez indicated no relevant financial relationships. Anshu Wadehra indicated no relevant financial relationships. Mahvish Khalid indicated no relevant financial relationships. Hamid-Reza Moein indicated no relevant financial relationships. Enofe Ikponmwosa indicated no relevant financial relationships. Diana Kakos indicated no relevant financial relationships. Paul Naylor indicated no relevant financial relationships. Bashar Mohamad indicated no relevant financial relationships.