Colon Cancer and Diverticular Disease Association: a Case-Control Study



To determine if there is an association between diverticular disease and colon cancer diagnoses with a secondary outcome of assessing other known risk factors for colon cancer. Colon cancer and diverticular disease have many shared symptoms and risk factors; the association between the two has been debated for many years.


36 cases of colon cancer and 144 age- and sex-matched controls were identified from records at an outpatient endoscopy center in Georgia. These cases and controls then were subject to a retrospective chart review to obtain any known risk factor data points for both diverticular disease and colon cancer. A traditional conditional logistic regression and a stepwise conditional logistic regression model were used to analyze the data using significant data points (P < 0.05).


The final stepwise model found that systolic blood pressure (aOR = 1.027, 95% CI = 1.001 to 1.053), history of polyps (aOR = 0.106, 95% CI = 0.029 to 0.387), exercise (aOR = 0.311, 95% CI = 0.029 to 0.387), and history of diverticular disease (aOR = 0.269, 95% CI = 0.091 to 0.795) were protective factors significantly associated with colon cancer.


Presence and history of the removal of colorectal polyps, presence or history of diverticular disease, and exercise pose as protective factors against development of colon cancer.

This is a preview of subscription content, access via your institution.


  1. 1.

    Basch CH, Ethan D, MacLean SA, Garcia P, Basch CE. Readability of colorectal cancer online information: a brief report. Int J Prev Med. 2018;9:77–7.

  2. 2.

    Elisei W, Brandimarte G, Tursi A. Management of diverticulosis: what’s new? Minerva Med. 2017;108(5):448–63.

    PubMed  Google Scholar 

  3. 3.

    Mortensen LQ, Burcharth J, Andresen K, Pommergaard HC, Rosenberg J. An 18-year nationwide cohort study on the association between diverticulitis and colon cancer. Ann Surg. 2017;265(5):954–9.

    Article  Google Scholar 

  4. 4.

    Jaruvongvanich V, Upala S, Sanguankeo A. Association between diverticulosis and colonic neoplasia: a meta-analysis. Am J Gastroenterol. 2016;111:576.

    CAS  Article  Google Scholar 

  5. 5.

    Haggar FA, Boushey RP. Colorectal cancer epidemiology: incidence, mortality, survival, and risk factors. Clin Colon Rectal Surg. 2009;22(4):191–7.

    Article  Google Scholar 

  6. 6.

    Böhm SK. Risk factors for diverticulosis, diverticulitis, diverticular perforation, and bleeding: a plea for more subtle history taking. Viszeralmedizin. 2015;31(2):84–94.

    PubMed  PubMed Central  Google Scholar 

  7. 7.

    Force USPST. Screening for colorectal cancer: us preventive services task force recommendation statement. JAMA. 2016;315(23):2564–75.

    Article  Google Scholar 

  8. 8.

    de Menezes RF, Bergmann A, Thuler LC. Alcohol consumption and risk of cancer: a systematic literature review. Asian Pacific J Cancer Prev : APJCP. 2013;14(9):4965–72.

    Article  Google Scholar 

  9. 9.

    Cooper GS, Xu F, Schluchter MD, Koroukian SM, Barnholtz Sloan JS. Diverticulosis and the risk of interval colorectal cancer. Dig Dis Sci. 2014;59(11):2765–72.

    Article  Google Scholar 

  10. 10.

    Lam TJ, Meurs-Szojda MM, Gundlach L, et al. There is no increased risk for colorectal cancer and adenomas in patients with diverticulitis: a retrospective longitudinal study. Colorectal Dis : the official journal of the Association of Coloproctology of Great Britain and Ireland. 2010;12(11):1122–6.

    CAS  Article  Google Scholar 

  11. 11.

    Krones CJ, Klinge U, Butz N, Junge K, Stumpf M, Rosch R, et al. The rare epidemiologic coincidence of diverticular disease and advanced colonic neoplasia. Int J Color Dis. 2006;21(1):18–24.

    CAS  Article  Google Scholar 

  12. 12.

    Longnecker MP, Gerhardsson le Verdier M, Frumkin H, Carpenter C. A case-control study of physical activity in relation to risk of cancer of the right colon and rectum in men. Int J Epidemiol. 1995;24(1):42–50.

    CAS  Article  Google Scholar 

Download references


Thank you to Changwei Li, MD, PhD, MPH, and Justin Ingels, PhD(c), MPH, MS for the encouragement and guidance on general case-control study designs. Thank you to the staff at Athens Gastroenterology Association for allowing the authors to ascertain and utilize de-identified patient data for this study.

Author information



Corresponding author

Correspondence to Maggie B. Kearney.

Ethics declarations

This study was approved by the Institutional Review Board of the University of Georgia.

Conflict of Interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kearney, M.B., Williams, J.M. & Ebell, M.H. Colon Cancer and Diverticular Disease Association: a Case-Control Study. J Gastrointest Canc 52, 120–124 (2021).

Download citation


  • Colon Cancer
  • Diverticular Disease
  • Colorectal Polyps
  • Screening
  • Protective Factors