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Endoscopy 2024; 56(07): 471-481
DOI: 10.1055/a-2264-8199
Original article

Risk of a post-colonoscopy colorectal cancer in patients with diverticular disease: a population-based cohort study

Frederikke S. Troelsen 
1   Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark (Ringgold ID: RIN11297)
2   Department of Surgery, Randers Regional Hospital, Randers, Denmark (Ringgold ID: RIN53198)
,
Henrik T. Sørensen
1   Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark (Ringgold ID: RIN11297)
,
Rune Erichsen
1   Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark (Ringgold ID: RIN11297)
2   Department of Surgery, Randers Regional Hospital, Randers, Denmark (Ringgold ID: RIN53198)
› Author AffiliationsSupported by: Novo Nordisk Fonden NNF19OC0058609
Supported by: Kræftens Bekæmpelse R247-A14719
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Beyond the scope: diverticular disease and post-colonoscopy colorectal cancerEndoscopy 2024; 56(07): 482-483
DOI: 10.1055/a-2309-5998

Abstract

Background Post-colonoscopy colorectal cancers (PCCRCs) may account for up to 30% of all colorectal cancers (CRCs) diagnosed in patients with diverticular disease; however, absolute and relative risks of PCCRC among these patients undergoing colonoscopy remain unknown.

Methods We performed a cohort study (1995–2015) including patients with and without diverticular disease who underwent colonoscopy. We calculated 7–36-month cumulative incidence proportions (CIPs) of PCCRC. We used Cox proportional hazards regression models to compute hazard ratios (HRs) of PCCRC, comparing patients with and without diverticular disease, as a measure of relative risk. We calculated 3-year PCCRC rates, as per World Endoscopy Organization recommendations, to estimate the proportion of CRC patients with and without diverticular disease who were considered to have PCCRC. We stratified all analyses by PCCRC location.

Results We observed 373 PCCRCs among 56 642 patients with diverticular disease and 1536 PCCRCs among 306 800 patients without diverticular disease. The PCCRC CIP after first-time colonoscopy was 0.45% (95%CI 0.40%–0.51%) for patients with and 0.36% (95%CI 0.34%–0.38%) for patients without diverticular disease. Comparing patients with and without diverticular disease undergoing first-time colonoscopy, the adjusted HR was 0.84 (95%CI 0.73–0.97) for PCCRC and 1.23 (95%CI 1.01–1.50) for proximal PCCRCs. The 3-year PCCRC rate was 19.0% (22.3% for proximal PCCRCs) for patients with and 6.5% for patients without diverticular disease.

Conclusions Although the absolute risk was low, the relative risk of proximal PCCRCs may be elevated in patients with diverticular disease undergoing colonoscopy compared with patients without the disease.

Supplementary Material



Publication History

Received: 13 July 2023

Accepted after revision: 08 February 2024

Accepted Manuscript online:
08 February 2024

Article published online:
13 March 2024

© 2024. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

Letter to this article:

Risk of metachronous colorectal cancer in patients with diverticular diseaseEndoscopy 2024; 56(10): 806-807
DOI: 10.1055/a-2317-7772

 

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