SEARCHCROSS-SECTIONALgastroenterology, oncology

cross-sectional·gastroenterology, oncology, epidemiology, observational study·PMC10119047

The connection between diverticulosis and colonic superficial neoplastic lesions in patients who underwent screening colonoscopy

International Journal of Colorectal Disease · 13 authors, 4 centres

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TL;DR

The study aimed to evaluate the association between colonic diverticulosis and colonic neoplastic lesions.

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The study aimed to evaluate the association between colonic diverticulosis and colonic neoplastic lesions. The overall prevalence of diverticulosis was 35.11% and of polyps was 47.04%. A univariate analysis showed a statistically significant association between diverticula and adenomas or colorectal cancer. However, a multivariate logistic regression analysis adjusting for age, gender, and family histories found that only age was significantly associated with the development of colorectal adenomas or cancer, with an odds ratio of 1.05 per year of age. The authors conclude that while an association exists, the cross-sectional design prevents establishing a cause-effect relationship and that the link may be driven by a shared factor like advanced age.

STUDY TYPE

cross-sectional

SPECIALTY

gastroenterology

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100% · A

ORIGINAL PAPER

PMC10119047

The connection between diverticulosis and colonic superficial neoplastic lesions in patients who underwent screening colonoscopy

International Journal of Colorectal Disease

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ABSTRACT

Purpose If could be a potential pathophysiological connection between colonic diverticula and colonic superficial neoplastic lesions, beyond the shared risk factors, has been a subject of debate in the last years. This study tries to evaluate the association between diverticulosis and colonic neoplastic lesions. Methods This is a cross-sectional study including asymptomatic patients who underwent a screening colonoscopy (patients with a positive fecal occult blood test under the regional program of colorectal cancer (CRC) screening), surveillance after polypectomy resection, or familiarity (first-degree relatives) between 2020 and 2021 to evaluate the association between diverticula and colonic polyps. A multivariate analysis with multiple logistic regression and odds ratio (OR) to study the independent association between adenomas and adenocarcinomas was performed. Results One thousand five hundred one patients were included. A statistically significant association between adenomas or CRC alone and colonic diverticula was found ( p = 0.045). On a multivariate analysis of demographic (age, gender) and clinical parameters (familiarity for diverticula and adenoma/CRC), only age was significantly associated with the development of colorectal adenomas or cancer (OR 1.05, 95% CI 1.03–1.07, p < 0.0001). Conclusions This study showed a statistically significant association between diverticula and colonic adenomas. However, it is impossible to establish a cause-effect relationship due to the intrinsic characteristics of this study design. A study with a prospective design including both patients with diverticulosis and without colonic diverticula aimed at establishing the incidence of adenoma and CRC could help to answer this relevant clinical question, since a potential association could indicate the need for closer endoscopic surveillance.

CITATION EXPORT

M. Valvano, V. Vezzaro, S. Fabiani et al.. The connection between diverticulosis and colonic superficial neoplastic lesions in patients who underwent screening colonoscopy. International Journal of Colorectal Disease. (2023). https://doi.org/10.1007/s00384-023-04399-5

AUTHORS

13 · 4 CENTRES

M. Valvano, V. Vezzaro, S. Fabiani, A. Capannolo, E. Sgamma, N. Cesaro, G. Valerii, S. Longo, C. Barbera, L. Lombardi, A. Viscido, S. Necozione, G. Latella

1https://ror.org/01j9p1r26grid.158820.60000 0004 1757 2611Division of Gastroenterology, Hepatology, and Nutrition, Department of Life, Health and Environmental Sciences, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 L’Aquila, Italy
2Diagnostic and Surgical Endoscopy Unit, San Salvatore Academic Hospital, L’Aquila, Italy
3Gastroenterology and Endoscopy Unit, Ospedale G. Mazzini, 64100 Teramo, Italy
4https://ror.org/01j9p1r26grid.158820.60000 0004 1757 2611Epidemiology Unit, Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy