African American patients with ulcerative colitis have no greater risk of developing colorectal cancer (CRC) than white patients with ulcerative colitis, despite a reported increased risk of sporadic CRC in African Americans and ulcerative colitis being a risk factor for CRC.

US researchers used Veterans Affairs (VA) databases for a retrospective cohort study that included nearly 21,000 patients diagnosed with ulcerative colitis between 1998 and 2009—spanning 112,243 patient years of follow-up. “The VA is the largest integrated health-care system in the USA,” explains author Jason Hou, “and their comprehensive data sets have been sources of pivotal research in other diseases.”

The overall incidence of CRC was 163 per 100,000 patient years, comparable to other reports on the risk of CRC for patients with ulcerative colitis. In the African American and white cohorts, the CRC incidence was 180 and 158 per 100,000 patient years, respectively.

African American race was not significantly associated with an increased risk of CRC in patients with ulcerative colitis; this finding was unchanged by multivariate analyses adjusting for factors such as frequency of VA visits, gender, age, comorbidities or VA priority level (a surrogate indicator of income status).

A strength of this study, highlighted by the authors, is that it encompassed the largest single cohort of African Americans with ulcerative colitis. A previous study of VA patients showed a lack of racial disparity in sporadic CRC outcomes, indicating that health-care access could be a factor. “More research on the effects of race on ulcerative-colitis-associated CRC in nonveterans is needed,” says Hou.