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Diverticular Disease of the Colon01:27

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Inflammatory bowel disease is a group of chronic disorders marked by recurrent inflammation of the gastrointestinal tract due to an abnormal immune response against gut microflora. This leads to tissue damage. The two main forms are Crohn’s disease and ulcerative colitis.Crohn’s DiseaseCrohn’s disease is a relapsing inflammatory disorder that can affect any part of the GI tract, from the mouth to the anus. It involves all layers of the bowel wall (transmural) and shows “skip lesions” in which...
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Is diverticular disease associated with colonic malignancy?

Anders Ekbom1

  • 1Karolinska Institutet, Department of Medicine Solna, Clinical Epidemiology Unit T2, Karolinska University Hospital, Stockholm, Sweden. anders.ekbom@ki.se

Digestive Diseases (Basel, Switzerland)
|May 11, 2012
PubMed
Summary

The link between diverticular disease and colon cancer is not supported by current evidence. Earlier studies suggested a connection, but newer research and critical evaluation show no clear association, impacting clinical practice.

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Area of Science:

  • Gastroenterology
  • Epidemiology
  • Oncology

Background:

  • Diverticular disease and colon cancer share epidemiological similarities, including rising incidence in Westernized populations and increasing age-specific rates.
  • Early hypotheses suggested an association between diverticular disease and an increased risk of colon cancer, particularly on the left side.

Purpose of the Study:

  • To critically evaluate the evidence supporting an association between diverticular disease and colonic malignancy.
  • To assess the impact of improved diagnostic methods and potential biases on the interpretation of this association.

Main Methods:

  • Review and critical evaluation of observational studies investigating the link between diverticular disease and colon cancer.
  • Analysis of methodological limitations including selection bias, confounding by indication, and surveillance bias.

Main Results:

  • Initial observational studies suggested an increased risk of colon cancer in patients with diverticular disease, but results were inconsistent.
  • More recent studies using advanced diagnostic methods do not strongly support this association.
  • Surveillance bias, where patients with diverticular disease undergo more intense diagnostic scrutiny, complicates interpretation.

Conclusions:

  • The proposed association between diverticular disease and colonic malignancy is not evidence-based.
  • This conclusion should influence clinical practice and screening program strategies for patients with diverticular disease.