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Cancer risk in patients with diverticular disease: a nationwide cohort study.

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BACKGROUND There are little data on diverticular disease and cancer development, other than colorectal cancer. METHODS We conducted a population-based, matched cohort study with linkage of nationwide registers to the… Click to show full abstract

BACKGROUND There are little data on diverticular disease and cancer development, other than colorectal cancer. METHODS We conducted a population-based, matched cohort study with linkage of nationwide registers to the ESPRESSO histopathology cohort. We included 75,704 patients with a diagnosis of diverticular disease and colorectal histopathology and 313,480 reference individuals from the general population matched on age, sex, calendar year, and county. Cox proportional hazards models estimated multivariable-adjusted hazard ratios (HRs) for associations between diverticular disease and overall cancer and specific cancers. RESULTS Over a median follow-up of 6 years, we documented 12,846 incident cancers among patients with diverticular disease and 43,354 incident cancers among reference individuals from the general population. Compared to reference individuals, patients with diverticular disease had significantly increased overall cancer incidence (24.5 vs. 18.1 per 1,000 person-years), equivalent to 1 extra cancer case in 16 individuals with diverticular disease followed for ten years. After adjusting for covariates, having a diagnosis of diverticular disease was associated with a 33% increased risk of overall cancer (95% confidence interval (CI)=1.31-1.36). The risk increases also persisted compared to siblings as secondary comparators (HR = 1.26; 95%CI = 1.21-1.32). Patients with diverticular disease also had increased risk of specific cancers, including colon cancer (HR = 1.71; 95%CI = 1.60-1.82), liver cancer (HR = 1.72; 95%CI = 1.41-2.10), pancreatic cancer (HR = 1.62; 95%CI = 1.42-1.84), and lung cancer (HR = 1.50; 95%CI = 1.39-1.61). The increase in colorectal cancer risk was primarily restricted to the first year of follow-up, and especially early cancer stages. CONCLUSIONS Patients with diverticular disease who have colorectal histopathology have an increased risk of overall incident cancer.

Keywords: diverticular disease; risk; histopathology; cancer; patients diverticular

Journal Title: Journal of the National Cancer Institute
Year Published: 2022

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