Colonic diverticulosis is associated with an increased adenoma detection rate in patients undergoing first-time screening colonoscopy

Abstract

Background: Diverticulosis is a common finding in patients undergoing colonoscopy. The effect of colonic diverticulosis on the colorectal adenoma detection rate (ADR) and other colonoscopy quality indicators remains unclear. Objectives: To determine if colonic diverticulosis is associated with differences in (1) colorectal ADR and (2) other quality indicators and operating characteristics in patients undergoing first-time screening colonoscopy. Methods: Retrospective cohort study conducted at an outpatient surgical center affiliated with an academic medical center. Results: 300 consecutive patients (190 women) with a median age of 57 years (range: 23-70 years) who underwent colonoscopy for various indications were included. 108 (36%) of these 300 patients had diverticulosis found on colonoscopy. 142 (47.3%) of these patients (88 women, median age of 52 years) underwent their first screening colonoscopy. In this population, the frequency of colonic diverticula was 39.2%, and the ADR was 47.5% for patients with diverticulosis and 27.4% for patients without diverticulosis. Multivariate analysis revealed that the presence of diverticulosis had an associated odds ratio of 2.3 (p=0.04) in favor of finding at least one adenoma. No statistically significant differences were found among the rates of total colonoscopy, median scope insertion and withdrawal times, and the amounts of midazolam and fentanyl required for sedation when patients with diverticulosis were compared to those without diverticulosis. Conclusion: Colonic diverticulosis was associated with an increased ADR in patients undergoing first-time screening colonoscopy. The presence of colonic diverticulosis did not adversely affect the cecal intubation rate, scope insertion or withdrawal times, or sedation requirements.

Association between Diverticular Disease and Pre-Neoplastic Colorectal Lesions in an Urban African-American Population

“…Another study by Morini et al [10, 11] has also asserted higher risk of harboring adenomas, advanced adenomas in sigmoid colon of patients with DD. Gohil et al reported in a retrospective cohort study an increased adenoma detection rate in patients with diverticulosis, undergoing colonoscopy [17]. Findings of all of the above studies are consistent with our results.…”

“…Our findings are comparable to some previous studies. First, Gohil et al in their retrospective review of 300 patients reported that 36% of them had DD and 47.3% had adenoma [17, 18]. Our findings that that adenoma was detected in 43% are similar to Gohil et al’s findings [17, 18].…”

“…Colorectal adenoma directly predisposes individuals to invasive adenocarcinoma [16]. There have been conflicting reports on the potential association between DD and colorectal neoplasm [10, 11, 14, 17–20]. This study to our knowledge is the first to assess any association between DD and precancerous colorectal lesions in an urban African-American population.…”

A felső és alsó endoszkópiák indikációja, a diagnózisok megoszlása és minőségi mutatók 2010–2011-ben a Semmelweis Egyetem I. Belgyógyászati Klinikáján

“…Az általunk megfigyelt 6,9%-os előfordulási gyakoriság igen magasnak tekinthető, azonban megfelel más, hasonlóan idős, polimorbid betegeket nem kizáró betegpopulációjú vizsgálatok adatainak [40,41]. A diverticulosis prevalenciája 40 éves kor alatt 5%, 60 év feletti korcsoportban azonban már meghaladja a 30%-ot [42,43]. Vizsgálatunkban 22,4%-ban fordult elő diverticulosis.…”

“…A leggyakoribb diagnózisok a vastagbélpolip és a vastagbél-diverticulosis voltak. Ezen laesiók találati ará-nyában nem volt különbség a vérző és nem vérző betegpopuláció között, és a gyakoriságok megfelelnek a korábban említett irodalmi adatoknak [35,36,42,43]. Bár a diverticulumokból eredő vérzés az akut alsó GI-vérzé-sek leggyakoribb oka (24-47%), a diverticulumok csak igen csekély hányadából származik vérzés [47,48].…”