S1538: Colonoscopic Evaluation After Acute Diverticulitis: Is There an Association With Colonic Malignancy?

Meta-analysis of the role of colonoscopy after an episode of left-sided acute diverticulitis

“…0·9 to 2·8) per cent. The slightly lower prevalence compared with the present result may be explained by the fact that the 2014 meta‐analysis included two studies in which some patients were diagnosed by ultrasonography, one study in which colonic evaluation was performed by barium enema or CT colonography in some patients, one study that undertook colonoscopies up to 2 years before the episode of acute diverticulitis, two studies with overlapping patients cohorts, and one conference abstract that was never published as a full paper.…”

“…Two reviews 24,44 included studies 26,29,35,36 of patients with complicated diverticulitis rather than the intended uncomplicated disease only. Furthermore, these previous systematic reviews included several studies or subgroups of patients specifically excluded from the present review because the diverticulitis diagnoses were made partly using ultrasonography 45,46,51 and not CT, colonoscopies were performed up to 2 years before 48 or up to 11 years after 35 the acute diverticulitis episode, or studies were only published as a conference abstract 50,52,53 . Moreover, one of the systematic reviews 43 reported a crude mean proportion instead of using a fixed-or random-effects model with a pooled, weighted mean proportion.…”

The incidence of colon cancer among patients diagnosed with left colonic or sigmoid acute diverticulitis is higher than in the general population

“…Despite our cohort's relatively large number of included subjects and our very similar incidence of colon carcinoma compared to other studies [12][13][14][15][16][17][18][19][20][21][32][33][34], no other variables, such as gender, Hb value, the presence of an anaemia, or a Hinchey score [1a, were identified as predictors of colon carcinoma. Previous studies also failed to reach consensus about the latters', therefore highlighting the difficulties in identifying patients needing an endoscopic evaluation after an initial diagnosis of diverticulitis.…”

“…The short-term incidence of colon carcinoma in a population diagnosed with acute diverticulitis has therefore been recently investigated by some authors [12][13][14][15][16][17][18][19][20][21], whose results have been summarized by a meta-analysis, and was found to be 1.6 % [22]. This incidence was described to be lower in patients presenting with uncomplicated diverticulitis compared to complicated disease, with reported incidences of, respectively, 0.3 and 7.6 % [22].…”

Colonoscopy after CT Diagnosis of Diverticulitis to Exclude Colon Cancer: A Systematic Literature Review

“…With use of these criteria, the overall accuracy of CT for the diagnosis of acute in 20 of 117 patients-three of whom received a diagnosis of colon cancer at surgery. Another study, by Elramah et al (6), found a masslike lesion in seven of 115 patients, from which two cancers were later found. Clearly, if a masslike lesion is found in the setting of acute diverticulitis, appropriate follow-up to char ac teristics of the subjects in studies advocating follow-up.…”