Background:
The etiology of diverticulitis is multifactorial and poorly understood. We estimated the familiality of diverticulitis using the Utah Population Database (UPDB), a statewide database linking medical records with genealogy data.
Study Design:
We identified patients with diverticulitis diagnosed between 1998-2018 and age- and sex-matched controls in the UPDB. Risk of diverticulitis in family members of cases and controls was calculated using multivariable Poisson models. We performed exploratory analyses to determine the association of familial diverticulitis with severity of disease and age of onset.
Results:
The study population included 9,563 diverticulitis cases (with 229,647 relatives) and 10,588 controls (with 265,693 relatives). Relatives of cases were more likely to develop diverticulitis (incidence rate ratio (IRR) 1.5, 95%CI 1.4,1.6) compared with relatives of controls. Further, there was an elevated risk of diverticulitis among first-degree (IRR 2.6, 95% CI 2.3,3.0), second-degree (IRR 1.5, 95%CI 1.3,1.6), and third-degree relatives of cases (IRR 1.3, 95%CI 1.2,1.4). Complicated diverticulitis was more common among relatives of cases compared with relatives of controls (IRR 1.6, 95%CI 1.4,1.8). Age at diverticulitis diagnosis was similar between groups (relatives of cases 0.2 years older than relatives of controls, 95%CI -0.5,0.9).
Conclusion:
Our results indicate that the first-, second-, and third-degree relatives of diverticulitis patients are at elevated risk of developing diverticulitis. This information may aid surgeons in counseling patients and family members about diverticulitis risk and can inform the development of future risk-stratification tools. Further work is needed to clarify the causal role and relative contribution of various genetic, lifestyle, and environmental factors in the development of diverticulitis.