Study explores link between diverticulitis and colorectal cancer

Editor's Note

Using data from the Gastrointestinal Quality Improvement Consortium registry, this 2024 study provides new insights into the practice of recommending colonoscopy following diverticulitis episodes to rule out colorectal cancer (CRC), Clinical Gastroenterology and Hepatology April 24 reports. This study, which analyzed over 4.5 million colonoscopies performed in the outpatient setting, aimed to determine the prevalence and likelihood of CRC and advanced colorectal neoplasia in patients who underwent colonoscopy either as follow-up for diverticulitis or for routine CRC screening.

The findings indicate that the overall prevalence of CRC in patients following diverticulitis is comparable to, and slightly lower than, those undergoing routine screening—0.31% vs 0.33%. Patients with simple diverticulitis exhibited even lower odds of CRC (adjusted OR 0.49), suggesting a reduced likelihood of missed cancers in this group compared to the general screening population. Patients with complicated diverticulitis showed a significantly higher risk, with CRC prevalence at 1.43% and an adjusted odds ratio of 3.57, indicating a more than threefold increase in risk compared to routine screening.

These findings seem to challenge the blanket recommendation for post-diverticulitis colonoscopies in all patients, suggesting that such procedures should be more targeted. Colonoscopies might be most warranted for patients with complications from diverticulitis or those not up-to-date with routine CRC screenings, the authors suggest.