Diverticulitis Is Associated with Increased Risk of Colon Cancer—A Nationwide Register-Based Cohort Study
Research output: Contribution to journal › Journal article › Research › peer-review
Standard
Diverticulitis Is Associated with Increased Risk of Colon Cancer—A Nationwide Register-Based Cohort Study. / Mortensen, Laura Quitzau; Andresen, Kristoffer; Thygesen, Lau; Pommergaard, Hans Christian; Rosenberg, Jacob.
In: Journal of Clinical Medicine, Vol. 13, No. 9, 2503, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Diverticulitis Is Associated with Increased Risk of Colon Cancer—A Nationwide Register-Based Cohort Study
AU - Mortensen, Laura Quitzau
AU - Andresen, Kristoffer
AU - Thygesen, Lau
AU - Pommergaard, Hans Christian
AU - Rosenberg, Jacob
N1 - Publisher Copyright: © 2024 by the authors.
PY - 2024
Y1 - 2024
N2 - Background: An association between diverticulitis and colon cancer has been proposed. The evidence is conflicting, and the guidelines differ regarding recommended follow-up with colonoscopy after an episode of diverticulitis. To guide regimes for follow-up, this study aimed to investigate if patients with diverticulitis have an increased risk of colon cancer. Methods: This study is reported according to the RECORD statement. We performed a cohort study with linked data from nationwide Danish registers. The inclusion period was 1997–2009, and the complete study period was 1995–2013. The primary outcome was the risk of developing colon cancer estimated using a Cox regression analysis with time-varying covariates. We performed a sensitivity analysis on a cohort of people with prior colonoscopies, comparing the risk of colon cancer between the diverticulitis group and the control group. Results: We included 29,173 adult males and females with diverticulitis and 145,865 controls matched for sex and age. The incidence proportion of colon cancer was 2.1% (95% confidence interval (CI) 1.9–2.3) in the diverticulitis group and 1.5% (95% CI 1.4–1.5) in the matched control group (hazard ratio 1.6; 95% CI 1.5–1.8). The risk of having a colon cancer diagnosis was significantly increased in the first six months after inclusion (hazard ratio 1.7; 95% CI 1.5–1.8), and hereafter there was a lower risk in the diverticulitis group compared with controls (hazard ratio 0.8; 95% CI 0.7–0.9). This protective effect lasted eight years. The increased risk of colon cancer during the first six months after diverticulitis was also found in the cohort with prior colonoscopies. Conclusions: The risk of a colon cancer diagnosis was significantly increased for patients with diverticulitis 0–6 months after the diagnosis of diverticulitis. Hereafter, we found a protective effect of diverticulitis until eight years later, possibly due to a screening effect. We recommend a follow-up colonoscopy after the first diagnosis of diverticulitis.
AB - Background: An association between diverticulitis and colon cancer has been proposed. The evidence is conflicting, and the guidelines differ regarding recommended follow-up with colonoscopy after an episode of diverticulitis. To guide regimes for follow-up, this study aimed to investigate if patients with diverticulitis have an increased risk of colon cancer. Methods: This study is reported according to the RECORD statement. We performed a cohort study with linked data from nationwide Danish registers. The inclusion period was 1997–2009, and the complete study period was 1995–2013. The primary outcome was the risk of developing colon cancer estimated using a Cox regression analysis with time-varying covariates. We performed a sensitivity analysis on a cohort of people with prior colonoscopies, comparing the risk of colon cancer between the diverticulitis group and the control group. Results: We included 29,173 adult males and females with diverticulitis and 145,865 controls matched for sex and age. The incidence proportion of colon cancer was 2.1% (95% confidence interval (CI) 1.9–2.3) in the diverticulitis group and 1.5% (95% CI 1.4–1.5) in the matched control group (hazard ratio 1.6; 95% CI 1.5–1.8). The risk of having a colon cancer diagnosis was significantly increased in the first six months after inclusion (hazard ratio 1.7; 95% CI 1.5–1.8), and hereafter there was a lower risk in the diverticulitis group compared with controls (hazard ratio 0.8; 95% CI 0.7–0.9). This protective effect lasted eight years. The increased risk of colon cancer during the first six months after diverticulitis was also found in the cohort with prior colonoscopies. Conclusions: The risk of a colon cancer diagnosis was significantly increased for patients with diverticulitis 0–6 months after the diagnosis of diverticulitis. Hereafter, we found a protective effect of diverticulitis until eight years later, possibly due to a screening effect. We recommend a follow-up colonoscopy after the first diagnosis of diverticulitis.
KW - colonoscopy
KW - colorectal cancer
KW - diverticular disease
KW - survival analysis
U2 - 10.3390/jcm13092503
DO - 10.3390/jcm13092503
M3 - Journal article
C2 - 38731032
AN - SCOPUS:85192754594
VL - 13
JO - Journal of Clinical Medicine
JF - Journal of Clinical Medicine
SN - 2077-0383
IS - 9
M1 - 2503
ER -
ID: 392446814