The Relationship Between Diverticular Disease And Neoplastic Colorectal Lesions

Aims Evolving data suggested that diverticulosis and neoplastic colorectal lesions share a common epidemiological trends and risk factors related to lower fiber diet and increasing age. However, the data on a relationship between diverticular disease (DD) and neoplastic colorectal lesions (NCL) are conflicting.

The aim is to determine the association between diverticulosis and NCL in a Tunisian population.

Methods We conducted a retrospective study on patients who underwent colonoscopic examination between January 2019 and December 2019 in a universityhospital in Tunisia. The presence of diverticulosis and neoplastic colorectal lesions was recorded using colonoscopy reports. Diverticulosis was defined as the presence of one or more colonic diverticula. NCL constitutes advanced adenoma (polyps greater than 1cm with villous histology or adenoma with high grade of dysplasia or invasive cancer) as well as colorectal cancer. The prevalence of NCL between individuals with and those without DD was compared. Multiple logistic regression was done to analyze the relationship between DD and NCL.

Results During the study period, 708 colonoscopies were performed. The prevalence of colonic diverticulosis was 0.1 % (70/708). Colonic diverticula predominated in the left colon and the sigmoid colon in 60 % and 53 % of cases, respectively. Bilateral localization was found in 34.3 % of cases.NCL were found in 77 patients; 31 patients (40 %) had colorectal cancer and 46 patients (60 %) had advanced adenomas (including 7 cases with high grade dysplasia adenomas). The left colon was the most frequent location of NLC (38 %).Diverticular disease was not associated with increased odds of NCL (OR=0.7, 95 % CI[0.4-1.5], p=0.47). Multivariable logistic regression analysis indicated that left-sided diverticulosis was not associated with an increased risk of NCL (OR 1.33; 95 % CI[0.14–12.6;p=0.8). Although, there was a positive correlation between diverticulosis and adenomas (p=0.008,Spearman = 0.3).

Conclusions In our study, colonic diverticulosis does not appear to be associated with an increased risk of neoplastic colorectal lesions.

Citation: Jlassi H, Sabbah M, Bellil N etal. eP304 THE RELATIONSHIP BETWEEN DIVERTICULAR DISEASE AND NEOPLASTIC COLORECTAL LESIONS. Endoscopy 2021; 53: S198.

Publication History

Article published online:
19 March 2021