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News

Colorectal cancer risk after an attack of uncomplicated diverticulitis

A study in this month's Scandanavian Journal of Gastroenterology evaluates the risk of colorectal cancer after an attack of uncomplicated diverticulitis.

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According to clinical guidelines, a colonoscopy is recommended after an attack of diverticulitis in order to exclude colorectal cancer.

This is based on studies prior to the use of computerized tomography (CT) for confirmation of the diagnosis.

Dr Einar Björnsson and colleagues from Iceland investigated the findings of a subsequent colonoscopy after an attack of uncomplicated diverticulitis.

The study cohort consisted of all patients with the diagnosis of uncomplicated diverticulitis, who underwent a subsequent colonoscopy 6–8 weeks later during a 6-years period in the National University Hospital of Iceland.

The diagnosis of diverticulitis was based on clinical symptoms verified with a CT of the abdomen.

The team obtained relevant clinical information from medical records, and from the Icelandic Cancer Registry.

3% of the colonic polyps were more than 1 cm in size
Scandanavian Journal of Gastroenterology

A total of 282 patients had uncomplicated diverticulitis, and 199 patients underwent endoscopy.

The team found that 2 patients had colorectal cancer, diagnosed with diverticulitis but did not recover clinically.
 
The researchers observed that all other patients recovered clinically.

Colonic polyps were found in 17% of cases.

The team found that in 58% of cases the histology demonstrated hyperplastic polyps, and in 39% adenoma with mild dysplasia.

The researchers noted that 3% of the colonic polyps were more than 1 cm in size.

Dr Björnsson's team concludes, "Among patients experiencing an attack of uncomplicated diverticulitis the frequency of colorectal cancer was equal to what might be expected compared to the average risk in the population."

"In these patients a routine colonoscopy in the absence of other clinical signs of colorectal cancer seems hardly necessary, if the clinical course is uneventful and the patient recovers."

Scand J Gastroenterol 2014: 49(5): 576-580
07 May 2014

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