Relationship between colonic diverticulosis and colon neoplasms in Japanese patients
Institutional review board statement: The protocol of this study was reviewed and approved by the Institutional Review Committee of New Tokyo Hospital, Shimane Prefectural Hospital and Matsue Red Cross Hospital, and registered in the University Hospital Medical Network Clinical Trials Registry (UMIN 000038985). This study was conducted in accordance with the Declaration of Helsinki.
Abstract
Background and Aim
Colonic diverticulosis (CD) has been reported to be associated with presence of colon neoplasms (CNs) in Western patients, since most of the associated risk factors are common between them. However, such correlation has not been fully investigated in Asian patients. In this study, the association of CNs with CD was evaluated in a multicenter investigation.
Methods
We enrolled 5633 patients who underwent both colonoscopy and esophagogastroduodenoscopy due to annual follow-up, screening for positive occult blood testing and abdominal symptoms between January 2016 and December 2017 at three institutions. The relationship between the presence of CNs and CD was investigated, and predictors for presence of CNs were determined by multivariate logistic analysis.
Results
The enrolled patients consisted of 1799 (31.9%) with CD (average age 70.0 years, male 64.0%) and 3834 without CD (66.0 years, male 52.9%), with the prevalence of CNs in those groups 46.6% and 44.2%, respectively (P = 0.090). Predictors for early colon cancer were shown to be age (OR 1.02, 95% CI 1.01–1.04, P = 0.010), laxatives use (OR 1.76, 95% CI 1.17–2.64, P = 0.007), gastric neoplasms (OR 2.16, 95% CI 1.23–3.81, P = 0.008), and CD (OR 1.64, 95% CI 1.16–2.31, P = 0.005). Early colon cancer in the distal colon was most frequently detected in patients with right-sided CD (RR 2.50, P = 0.001).
Conclusion
In Japanese patients, early colon cancer was more frequently found in those with as compared to those without CD. The presence of CD may be an important indicator for an index colonoscopy examination to detect colon cancer. (Clinical-trial-registry: UMIN000038985).
Conflict of interest
Author S.I. was supported by grants or donations from EA Pharma Co. Ltd., Astellas Pharma Inc., Zeria Pharmaceutical Co. Ltd., Daiichi Sankyo Co., Ltd. and Takeda Pharmaceutical Co. Ltd. Author Y.A. was supported by lecture fees from Takeda Pharmaceutical Co. Ltd. Other authors have no conflicts of interests.
