Diverticular inflammation and complication assessment does not predict diverticulitis in asymptomatic individuals

Recently, a 3‑step endoscopic scale, known as the Diverticular Inflammation and Complication Assessment (DICA), was introduced to predict the course of diverticular disease (DD), yielding some promising outcomes. However, analyses were performed only for symptomatic individuals.

The aim of our study was to prospectively evaluate the predictive value of DICA in asymptomatic individuals with no previous diagnosis of DD who underwent colorectal cancer screening colonoscopy.

We performed a prospective cohort study. All consecutive individuals, aged 55-65 years undergoing screening colonoscopy in a single center during a 6‑month period were assessed for eligibility. Those with diverticulosis were followed‑up for 12 months. Information on the course of the disease, symptoms, treatment, diverticulitis episodes confirmed by health care professionals, complications, and hospital admissions was obtained via telephone interviews conducted by doctors. Detailed patient data and medical conditions were evaluated.

Out of 3879 participants, 958 (24.7%) had diverticula. Of these, 872 (mean [SD] age, 61 [2] years; 49.8% women) completed the study. About 83.5%, 12.85%, and 3.67% of the patients were classified into the DICA 1, DICA 2, and DICA 3 group, respectively. Diverticulitis occurred in 12 (1.37%) patients. Hospital admission was needed in 5 of them. No surgical interventions were necessary. There were no significant relationships between the DICA score and diverticulitis or hospital admission. Previous abdominal surgery and appendectomy, the presence and severity of pain, bloating, and previous DD treatment were the only factors predisposing to diverticulitis.

In our cohort, the DICA scale had no predictive value for the occurrence of diverticulitis. Hence, it has a limited predictive value for occurrence of this condition and more studies on bigger cohorts are necessary to test its usefulness.