Premium
Risk of colorectal adenomas, advanced adenomas and cancer in patients with colonic diverticular disease: Systematic review and meta‐analysis
Author(s) -
Jaruvongvanich Veeravich,
Sanguankeo Anawin,
Wijarnpreecha Karn,
Upala Sikarin
Publication year - 2017
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/den.12701
Subject(s) - medicine , diverticular disease , odds ratio , colorectal cancer , meta analysis , diverticulosis , observational study , cohort study , gastroenterology , confidence interval , epidemiology , disease , oncology , cancer
Background and Aim Diverticular disease and colorectal neoplasia are common digestive disorders worldwide. Both diseases share epidemiological trends and certain risk factors including advancing age, physical inactivity, and Western diet and lifestyle. Studies assessing the association between these diseases reported inconsistent results. Thus, we conducted a systematic review and meta‐analysis to determine the association between diverticular disease and colorectal adenomas, advanced adenomas and cancer. Methods A comprehensive search of the databases MEDLINE and EMBASE was done from inception through March 2016. Inclusion criterion was the observational studies’ assessment of the association between diverticular disease and colorectal neoplasia in adult participants. Pooled OR and 95% confidence interval (CI) were calculated using a random effect. Results Data were extracted from 14 observational studies (11 cross‐sectional studies, one case–control study and two cohort studies). Diverticular disease was associated with increased odds of adenomas (OR = 1.67, 95% CI 1.27–2.21, 10 studies), but not associated with advanced adenomas (OR = 1.19, 95% CI 0.88–1.62, I 2 = 52%, four studies) or colorectal cancer (OR = 1.36, 95% CI 0.47–3.92, I 2 = 98%, seven studies). Conclusions Our meta‐analysis demonstrated that diverticular disease was associated with colorectal adenomas. Colonoscopists should be aware of this association and carefully examine the entire large bowel in individuals with diverticulosis.