Post-Diverticulitis Colonoscopy Was Not Associated with Higher Colonic Adenoma and Carcinoma: A Multicenter Case–Control Study
<i>Background and Objectives</i><b>:</b> Colonoscopy following an episode of acute diverticulitis is currently recommended to rule out underlying colon cancer. However, a number of studies have debated this recommendation. We aimed to explore whether patients with colonic div...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-07-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/57/7/682 |
| _version_ | 1827687351774609408 |
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| author | Amir Mari Tawfik Khoury Wisam Sbeit |
| author_facet | Amir Mari Tawfik Khoury Wisam Sbeit |
| author_sort | Amir Mari |
| collection | DOAJ |
| description | <i>Background and Objectives</i><b>:</b> Colonoscopy following an episode of acute diverticulitis is currently recommended to rule out underlying colon cancer. However, a number of studies have debated this recommendation. We aimed to explore whether patients with colonic diverticulosis who experienced an episode of acute diverticulitis had higher prevalence colonic pathologies, essentially colonic adenomas and colorectal carcinoma (CRC) on a follow-up colonoscopy. <i>Materials and Methods</i>: We performed a multicenter retrospective study that included patients with a diagnosis diverticulosis as the control group and allocated patients after diverticulitis according to computed tomography (CT) scan and clinical presentation that had performed colonoscopy within 6 months from the acute diverticulitis episode. We compared the detection rate of colonic pathologic findings in both groups. <i>Results:</i> Overall, 367 patients were included. Of them, 134 patients experienced an episode of diverticulitis vs. 233 patients who did not have diverticulitis. On univariate analysis, there was no difference between all pathological findings (CRC, colonic adenomas; OR (odds ratio) 1.51, <i>p</i> = 0.085), and even for each pathological findings alone, there was no difference (for colonic adenomas, <i>p</i> = 0.07; for CRC, <i>p</i> = 0.87). Further sub-analysis revealed that only male gender (OR 4.03, <i>p</i> = 0.004) and smoking (OR 8.67, <i>p</i> < 0.0001) correlated with colonic adenomas and CRC, while moderate to severe disease was not correlated with colonic pathological findings (OR 0.86, 95% CI (confidence interval) 0.4–1.82, <i>p</i> = 0.68). <i>Conclusions:</i> Post-diverticulitis screening colonoscopy has not found a higher rate of colonic pathological findings, especially colonic neoplasia. Decision to perform colonoscopy after acute diverticulitis should be individualized based on risk stratification of colonic neoplasia. |
| first_indexed | 2024-03-10T09:32:14Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-10T09:32:14Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-3655c8b6e21445c68abd3920df5fe0742023-11-22T04:21:02ZengMDPI AGMedicina1010-660X1648-91442021-07-0157768210.3390/medicina57070682Post-Diverticulitis Colonoscopy Was Not Associated with Higher Colonic Adenoma and Carcinoma: A Multicenter Case–Control StudyAmir Mari0Tawfik Khoury1Wisam Sbeit2Gastroenterology and Endoscopy United, The Nazareth Hospital, EMMS, Nazareth 16100, IsraelFaculty of Medicine, Bar-Ilan University, Safed 1311502, IsraelFaculty of Medicine, Bar-Ilan University, Safed 1311502, Israel<i>Background and Objectives</i><b>:</b> Colonoscopy following an episode of acute diverticulitis is currently recommended to rule out underlying colon cancer. However, a number of studies have debated this recommendation. We aimed to explore whether patients with colonic diverticulosis who experienced an episode of acute diverticulitis had higher prevalence colonic pathologies, essentially colonic adenomas and colorectal carcinoma (CRC) on a follow-up colonoscopy. <i>Materials and Methods</i>: We performed a multicenter retrospective study that included patients with a diagnosis diverticulosis as the control group and allocated patients after diverticulitis according to computed tomography (CT) scan and clinical presentation that had performed colonoscopy within 6 months from the acute diverticulitis episode. We compared the detection rate of colonic pathologic findings in both groups. <i>Results:</i> Overall, 367 patients were included. Of them, 134 patients experienced an episode of diverticulitis vs. 233 patients who did not have diverticulitis. On univariate analysis, there was no difference between all pathological findings (CRC, colonic adenomas; OR (odds ratio) 1.51, <i>p</i> = 0.085), and even for each pathological findings alone, there was no difference (for colonic adenomas, <i>p</i> = 0.07; for CRC, <i>p</i> = 0.87). Further sub-analysis revealed that only male gender (OR 4.03, <i>p</i> = 0.004) and smoking (OR 8.67, <i>p</i> < 0.0001) correlated with colonic adenomas and CRC, while moderate to severe disease was not correlated with colonic pathological findings (OR 0.86, 95% CI (confidence interval) 0.4–1.82, <i>p</i> = 0.68). <i>Conclusions:</i> Post-diverticulitis screening colonoscopy has not found a higher rate of colonic pathological findings, especially colonic neoplasia. Decision to perform colonoscopy after acute diverticulitis should be individualized based on risk stratification of colonic neoplasia.https://www.mdpi.com/1648-9144/57/7/682diverticulitisadenomasCRCcolonoscopy |
| spellingShingle | Amir Mari Tawfik Khoury Wisam Sbeit Post-Diverticulitis Colonoscopy Was Not Associated with Higher Colonic Adenoma and Carcinoma: A Multicenter Case–Control Study Medicina diverticulitis adenomas CRC colonoscopy |
| title | Post-Diverticulitis Colonoscopy Was Not Associated with Higher Colonic Adenoma and Carcinoma: A Multicenter Case–Control Study |
| title_full | Post-Diverticulitis Colonoscopy Was Not Associated with Higher Colonic Adenoma and Carcinoma: A Multicenter Case–Control Study |
| title_fullStr | Post-Diverticulitis Colonoscopy Was Not Associated with Higher Colonic Adenoma and Carcinoma: A Multicenter Case–Control Study |
| title_full_unstemmed | Post-Diverticulitis Colonoscopy Was Not Associated with Higher Colonic Adenoma and Carcinoma: A Multicenter Case–Control Study |
| title_short | Post-Diverticulitis Colonoscopy Was Not Associated with Higher Colonic Adenoma and Carcinoma: A Multicenter Case–Control Study |
| title_sort | post diverticulitis colonoscopy was not associated with higher colonic adenoma and carcinoma a multicenter case control study |
| topic | diverticulitis adenomas CRC colonoscopy |
| url | https://www.mdpi.com/1648-9144/57/7/682 |
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