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Association between sigmoid diverticulitis and left-sided colon cancer: a nested, population-based, case control
T Stefánsson1, A Ekbom, P Sparèn
1Dept. of Surgery, University Hospital, Uppsala, Sweden. tryggvis@landspitali.is
Scandinavian Journal of Gastroenterology
|October 30, 2004
Summary
Patients with sigmoid diverticulitis face a significantly higher long-term risk of developing left-sided colon cancer. This study confirms a causal link between sigmoid diverticulitis and increased colon cancer risk.
Area of Science:
- Gastroenterology
- Oncology
- Epidemiology
Background:
- Diverticular disease of the sigmoid colon is linked to increased colon cancer risk.
- Previous reports suggest a higher incidence of left-sided colon cancer in these patients.
Purpose of the Study:
- To compare the long-term colon cancer risk in patients with sigmoid diverticulitis versus those with asymptomatic diverticulosis.
- To investigate the extent of risk difference for colon cancer.
Main Methods:
- A cohort of 7159 patients diagnosed with diverticulosis or diverticulitis between 1965-1983 was followed.
- Colon cancer cases (n=64) were identified via the Swedish Cancer Registry and compared to 123 matched controls.
- Clinical diagnoses were assigned by a blinded observer reviewing patient charts.
Main Results:
- Patients diagnosed with sigmoid diverticulitis showed a 4.2-fold increased risk of left-sided colon cancer (95% CI 1.3-13.0).
- This increased risk persisted after adjusting for multiple clinical parameters in a multivariate analysis.
Conclusions:
- The study suggests a causal association between sigmoid diverticulitis and an elevated long-term risk of left-sided colon cancer.
- Sigmoid diverticulitis is a significant risk factor for developing colon cancer.