Diverticulosis linked to adenomas, but not cancer

Diverticulosis is significantly associated with adenomas, advanced adenomas, and neoplasia, but not with cancer alone, according to a study.

“However, the strength of association seems to be insufficient to impact on clinical practice,” the authors said.

In this systematic review and meta-analysis, studies comparing the prevalence of adenomas, advanced adenomas, cancer, or neoplasia between patients with and without diverticulosis were identified. The authors also performed subgroup comparisons.

Twenty-six studies, including a total of 419,623 patients, met the eligibility criteria. Of the patients, 27,092 had diverticulosis.

Data analysis revealed the significant association of diverticulosis with adenomas (odds ratio [OR], 1.88, 95 percent confidence interval [CI], 1.50‒2.25), advanced adenomas (OR, 1.49, 95 percent CI, 1.02‒2.16), and neoplasia (OR, 1.50, 95 percent CI, 1.11‒2.02). No significant association was seen between diverticulosis and cancer alone (OR, 1.01, 95 percent CI, 0.70‒1.47).

Subgroup analyses, which considered Caucasian and Asian populations, prospective and retrospective studies, screening or symptom settings, and between good or fair quality studies, confirmed these associations.

“Some epidemiological observations suggest an association between diverticulosis and adenoma/cancer in the colon,” the authors said. “However, an increased risk of colon neoplastic lesions in diverticulosis [patients] was found to be increased in some studies, but not in others, puzzling data interpretation.”