Colorectal cancer in Russian-speaking Jewish emigres: Community-based screening

OBJECTIVES: Colorectal cancer (CRC) screening by fecal occult blood testing and flexible sigmoidoscopy is recommended by many authorities for those ol der than age 50. Ashkenazi Jews have been shown to have a higher level of C RC and polyps than the general population. A subset of Ashkenazi Jews, Russ ian-speaking Jewish immigrants to the United States (RJIs), have not been s tudied extensively for CRC and may have additional risk factors not found i n other Ashkenazi populations. METHODS: A retrospective chart review was undertaken of fecal occult blood tests, endoscopy reports, and pathology reports of 132 RJIs and 124 non-RJI controls over age 50 between 1987 and 1999 at the Jewish Hospital of Cinci nnati Medical Outpatient Clinic. RESULTS: Mean ages at the time of diagnosis or flexible sigmoidoscopy were 68 yr for RJIs and 66 yr for the non-RJI patients. Of the RJI patients, 38. 7% had positive findings: 37 (28.0%) with lesions < 2 cm, five (3.8%) with lesions > 2 cm, and nine (6.8%) with CRC. Of the non-RJ1 control group pati ents, 16.9% had positive findings: 16 (12.9%) with lesions < 2 cm, three (2 .4%) with lesions > 2 cm, and two (1.6%) with CRC. Age- and sex-matched sta tistical analysis revealed significantly greater CRC and significantly more polyps > 2 cm for the RJI patients (p < 0.003). This is higher than in oth er studies of Ashkenazis, which show a 2.3% incidence, and in statistics fr om the National Cancer Institute, which reveal a national CRC incidence rat e for those over age 65 to be 0.30%. C, CONCLUSIONS. RJIs in our study have polyps > 2 cm and CRC at a rate of 10.6 %, as compared with 4.0% for in-clinic controls and a national average of 0 .30% for patients over age 65. This suggests a need for more aggressive scr eening of this patient population for CRC. (Am J Gastroenterol 2001;96:2755 -2760. (C) 2001 by Am. Coll. of Gastroenterology).