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Colonic diverticulosis does not increase risk for colorectal cancer
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Recent findings published in the American Journal of Gastroenterology suggested colonic diverticulosis did not increase the risk for colorectal or advanced adenomas, contrary to previous research.
“Colonic diverticula are associated with a spectrum of morbid and mortal disease, including diverticulitis, diverticular bleeding and free rupture. Now there are reports that diverticula are associated with an increased risk of missed colorectal cancers,” Anne F. Peery, MD, assistant professor at the University of North Carolina School of Medicine, told Healio Gastroenterology. “We found no association between diverticula and adenomas.”
Anne F. Peery
Peery and colleagues analyzed data from a prospective study of 624 patients aged 30 years and older who underwent colonoscopy screening between 2013 and 2015 at the University of North Carolina Hospitals in Chapel Hill. During the screening, patients were examined for colorectal polyps and colonic diverticula. During the colonoscopy, the number and location of all colonic diverticula were documented. The researchers used logistic regression estimate odds ratios and 95% confidence intervals, adjusted for potential confounders.
The researchers found 35% (n = 216) of patients had one or more colorectal adenomas. Colonic diverticulosis on colonoscopy did not increase the risk of adenomas (OR = 1; 95% CI, 0.7-1.4) or advanced adenomas (OR = 0.8; 95% CI, 0.4-1.5). Colonic diverticulosis did not increase the risk of proximal (OR = 1; 95% CI, 0.6-1.6) or distal adenomas (OR = 1; 95% CI, 0.6-1.7). Having 10 or more diverticula did not increase the risk of adenomas compared with having none (OR = 1.1; 95% CI, 0.7-1.8).
According to the researchers, the reported increased risk could be the result of detection bias, as patients with missed colorectal cancers have had more colonoscopies and greater opportunity for a diagnosis of diverticulosis vs. patients with sporadic colorectal cancers.
“Any association between missed cancers and colonic diverticula is not due to greater risk for neoplasia in patients with diverticula,” Peery said. “It’s important to point out that because individuals with diverticulosis may have distorted colonic architecture, it might be easier for endoscopists to miss lesions so a careful exam is important.”
Disclosures: The researchers report no relevant financial disclosures.
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