Risk of colorectal cancer following CT-verified acute diverticulitis -a nationwide population-based cohort study

• AIM: Routine colonoscopy to exclude colorectal cancer (CRC) after CT-verified acute diverticulitis is controversial. This study aimed to compare the incidence of CRC in acute diverticulitis patients with that in the general population. METHOD: Patients with an emergency admission for diverticular disease, to any Norwegian hospital, between January 1st , 2008 and December 31st , 2010 were included through identification in the Norwegian Patient Registry using International Classification of Diseases (ICD-10) codes K57.1-9. To estimate the age-specific distribution of CT-verified acute uncomplicated diverticulitis (AUD) and acute complicated diverticulitis (ACD) in this nationwide study population, numbers from the largest Norwegian emergency hospital were used. Patients diagnosed with CRC within one year following the admission for acute diverticulitis were detected through cross-matching with the Cancer Registry of Norway. Based on both Norwegian age-specific incidence of CRC and estimated age-specific distribution of CT-verified diverticulitis, standard morbidity ratios (SMR) were calculated.RESULTS: A total of 7473 patients with emergency admissions for diverticular disease were identified (estimated CT-verified AUD n=3523, ACD n=1206), and of these 155 patients were diagnosed with CRC within one year. Eighty had a CT-verified diverticulitis at index admission (41 AUD; 51.3% and 39 ACD; 49.7%). Compared to the general population SMR was 6.6 following CT-verified AUD and 16.3 following ACD respectively.CONCLUSION: The risk of CRC is higher than in the general population, the first year after CT-verified acute diverticulitis, especially after ACD. This likely represents misdiagnosis of CRC as acute diverticulitis. Follow-up colonoscopy should be recommended to all patients admitted with acute diverticulitis.

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MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

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