Published online Oct 24, 2018. doi: 10.5306/wjco.v9.i6.119
Peer-review started: August 7, 2018
First decision: August 31, 2018
Revised: September 4, 2018
Accepted: October 9, 2018
Article in press: October 9, 2018
Published online: October 24, 2018
Processing time: 80 Days and 12.1 Hours
Colorectal cancer constitutes an important burden on the healthcare system. Screening at-risk populations to reduce colorectal cancer-related morbidity and mortality has become part of good clinical practice. However, recommendations regarding subgroups of patients with diverticular disease are subject to controversy.
Herein, we review the most recent literature regarding the prevalence of colorectal cancer in patients with diverticular disease, diverticulitis and uncomplicated diverticulitis.
The recent literature does not identify diverticular disease as a long-term risk factor for colorectal cancer. However, the risk of colorectal cancer is increased in the short-term period after hospitalization related to diverticular disease. According to a recent systematic review and meta-analysis, the prevalence of colorectal cancer is 1.6% in patients with acute diverticulitis who underwent colonoscopy. The risk of having colorectal cancer after an episode of acute diverticulitis is 44-fold higher than that of an age- and gender-adjusted reference population. Despite lower among patients with uncomplicated episode, the risk of colorectal cancer remains 40-fold higher in that subpopulation than that in the reference population.
To conclude, the recent literature describes an increased risk of colorectal cancer among patients with acute diverticulitis compared to the reference population. Colonoscopy is therefore recommended in patients with diverticulitis to exclude colorectal cancer.
Core tip: The present manuscript reviews the current literature reporting on the prevalence of colorectal cancer in patients with diverticular disease. The prevalence of colorectal cancer among subgroups of patients with diverticulitis and uncomplicated diverticulitis is discussed, with the objective of providing recommendations for colorectal cancer screening.