There is no increased risk for colorectal cancer and adenomas in patients with diverticulitis: a retrospective longitudinal study

Lam, T. J.; Meurs-Szojda, M. M.; Gundlach, Lars; Beliën, Jeroen A.M.; Meijer, Gerrit A.; Mulder, Chris J.; Felt‐Bersma, R. J. F.

doi:10.1111/j.1463-1318.2009.01992.x

Cited by 45 publications

(25 citation statements)

References 30 publications

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“…Stefansson et al, 14 for example, found an increased risk of left-sided colon cancer associated with patients with diverticulitis, whereas others have reported no association. [15][16][17] The lack of consensus appears, in part at least, to be caused by different study designs and methodologies. Meurs-Szojda et al, 16 for example, included all patients who underwent colonoscopy and found no difference in rates of colorectal cancer in patients with and without diverticulosis or diverticulitis.…”

Section: Discussionmentioning

confidence: 96%

Is Colonoscopy Still Mandatory After a CT Diagnosis of Left-Sided Diverticulitis: Can Colorectal Cancer be Confidently Excluded?

Lau

Spilsbury

Farooque

et al. 2011

Diseases of the Colon &Amp; Rectum

108

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Section: Discussionmentioning

confidence: 96%

Is Colonoscopy Still Mandatory After a CT Diagnosis of Left-Sided Diverticulitis: Can Colorectal Cancer be Confidently Excluded?

Lau

Spilsbury

Farooque

et al. 2011

Diseases of the Colon &Amp; Rectum

108

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“…The common aetiological factors between both diseases would suggest a relatively high incidence of the simultaneous presence of diverticulosis and colon cancer, although contradictory results have also been published [1,2,7,8].…”

mentioning

confidence: 91%

Routine Screening for Colon Cancer after Conservative Treatment of Diverticulitis

Schout¹,

Bilgen²,

Groenen

2012

Dig Surg

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Background and Aims: It is generally advised to perform colonoscopy after conservatively treated diverticulitis because colon cancer may present itself with similar symptoms, laboratory and radiological results. With this study we investigated in what percentage of patients a malignancy was found by performing routine colonoscopy or radiologic imaging after a conservatively treated episode of diverticulitis, and whether this follow-up programme could be reserved for a selected group of patients. Methods: In our hospital, routine colonoscopy or, as a second choice, radiologic imaging has been standard practice over the last decade. We collected all colonoscopy and radiologic imaging results that were conducted of all 516 patients who were diagnosed with diverticulitis in this period. Results: Of those 516 patients, 378 had undergone colonoscopy, 45 radiologic imaging and 93 did not undergo any additional investigation. Eight cases of malignant neoplasia were found in those patients (2.1%), and an additional number of 40 adenomatous polyps (9.5%). Six out of 8 patients with colon cancer reported rectal blood loss, significant weight loss or persisting abdominal pain after being treated for diverticulitis. Conclusions: In patients who were conservatively treated with routine colonoscopy or radiologic imaging for apparent diverticulitis, a malignant tumour was found in the colon in 2.1% of them. If only performed in patients reporting alarm symptoms, a case of colon cancer would be missed in only 0.5% of patients conservatively treated for diverticulitis. Therefore, screening for colon cancer after conservative treatment of diverticulitis is only indicated in symptomatic patients.

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“…In a prospective study aimed at understanding the risks and benefits of early versus late colonoscopic follow-up in diverticulitis, Lahat et al (42) suggested that colonoscopy performed immediately after an episode of acute diverticulitis adds no clinical value. In a retrospective study, Lam et al (44) showed that the prevalence of colon cancer in patients with diverticulitis is lower than the lifetime risk of colon cancer. In a case-control study, Chintapalli et al (40) believed that the specificity of CT findings of diverticulitis and colon cancer is so high that an unequivocal diagnosis can be made with 100% accuracy for both diseases.…”

Section: Evidence-based Practice: Colonoscopy After Ct Diagnosis Of Dmentioning

confidence: 99%

Colonoscopy after CT Diagnosis of Diverticulitis to Exclude Colon Cancer: A Systematic Literature Review

Sai¹,

Velayos²,

Neuhaus³

et al. 2012

Radiology

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Purpose:To estimate the prevalence of underlying adenocarcinoma of the colon in patients in whom acute diverticulitis was diagnosed at computed tomography (CT) and to compare that to the prevalence of colon cancer in the general population. Materials and Methods:A comprehensive literature review was performed to find articles in which patients with CT diagnosis of acute diverticulitis underwent surgery, colonoscopy, or barium enema study within 24 weeks. Patients meeting these criteria were included for analysis. A pooled prevalence of cancer was calculated on the basis of a random effects model and compared qualitatively with the prevalence of cancer in the general population. The 95% confidence intervals around the prevalence of cancer in the study populations were determined. Results:Ten articles met the inclusion criteria. Data from these articles included only 771 patients who underwent surgery, colonoscopy, or barium enema study within 24 weeks of diagnosis. Fourteen patients were found to have colon cancer, for a prevalence of 2.1% (95% confidence interval: 1.2%, 3.2%). This compares to a calculated estimated prevalence of 0.68% among U.S. adults older than 55 years.

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There is no increased risk for colorectal cancer and adenomas in patients with diverticulitis: a retrospective longitudinal study

Cited by 45 publications

References 30 publications

Is Colonoscopy Still Mandatory After a CT Diagnosis of Left-Sided Diverticulitis: Can Colorectal Cancer be Confidently Excluded?

Is Colonoscopy Still Mandatory After a CT Diagnosis of Left-Sided Diverticulitis: Can Colorectal Cancer be Confidently Excluded?

Routine Screening for Colon Cancer after Conservative Treatment of Diverticulitis

Colonoscopy after CT Diagnosis of Diverticulitis to Exclude Colon Cancer: A Systematic Literature Review

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