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Prevalence of colorectal cancer in acute uncomplicated diverticulitis and the role of the interval colonoscopy

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A Correction to this article was published on 29 May 2018

This article has been updated

Abstract

Purpose

Although computed tomography (CT) is the imaging modality of choice for diagnosing colonic diverticulitis today, there remains a risk of colorectal cancer mimicking diverticulitis due to overlapping imaging features. Current practice guidelines recommend interval colonoscopy after diverticulitis to exclude occult malignancy. Some authors have suggested that this may be unnecessary in patients with uncomplicated diverticulitis. The aim of our study was to examine the prevalence of occult colorectal cancer in patients with CT-proven acute uncomplicated diverticulitis in an Asian population.

Methods

This was a retrospective study of all patients admitted for CT-proven acute uncomplicated diverticulitis between 2007 and 2011 in a single institution. Colonoscopy and histopathology reports were reviewed for patients who underwent interval colonic evaluation. For patients who defaulted follow-up, national health records were reviewed for any subsequent diagnoses of colorectal cancer. The primary outcome was prevalence of colorectal cancer in the cohort. Secondary outcome was prevalence of advanced adenomas.

Results

A total of 227 patients with acute uncomplicated diverticulitis were included in our study. One hundred and thirty-five patients (59.5%) underwent follow-up colonic evaluation. The overall prevalence of colorectal cancer was 1.8%, with half these patients presenting with acute colonic obstruction after defaulting follow-up evaluation. Of the patients, 1.5% who underwent colonoscopy had advanced adenomas.

Conclusion

Prevalence of colorectal cancer in patients with CT-proven acute uncomplicated diverticulitis may not be as low as previously suggested. We recommend that patients with acute uncomplicated diverticulitis continue to be offered interval colonoscopy until larger studies demonstrate the safety of omission.

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Fig. 1

Change history

  • 29 May 2018

    The original version of this article, unfortunately, contained errors. The first and family names of the authors were interchanged. The correct author names are now correctly presented in this article. The original article has been corrected.]

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Authors and Affiliations

  1. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore

    Soh Nicholas Yock Teck

  2. Ministry of Health Holdings, Singapore, Singapore

    Chia Daryl Kai Ann

  3. Department of General Surgery, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Republic of Singapore

    Teo Nan Zun, Ong Calvin Jian Ming & Ramesh Wijaya

Authors
  1. Soh Nicholas Yock Teck
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  2. Chia Daryl Kai Ann
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  3. Teo Nan Zun
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  4. Ong Calvin Jian Ming
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  5. Ramesh Wijaya
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Corresponding author

Correspondence to Ramesh Wijaya.

Additional information

The original version of this article, unfortunately, contained errors. The first and family names of the authors were interchanged. The correct author names are now correctly presented in this article.

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Soh, N.Y.T., Chia, D.K.A., Teo, N.Z. et al. Prevalence of colorectal cancer in acute uncomplicated diverticulitis and the role of the interval colonoscopy. Int J Colorectal Dis 33, 991–994 (2018). https://doi.org/10.1007/s00384-018-3039-1

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  • DOI: https://doi.org/10.1007/s00384-018-3039-1

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