The relationship between diverticulosis and colorectal neoplasia

A meta-analysis

Hyun Jung Lee, Soo Jung Park, JaeHee Cheon, Tae Il Kim, Won Ho Kim, Hyun Jung Kim

Research output: Contribution to journalReview article

Abstract

Background/Aims Diverticulosis and colorectal neoplasia share epidemiological trends and risk factors which are common in Western countries and incidences increase with age. However, the data on an association between diverticulosis and colorectal neoplasia are conflicting. Thus, we performed a meta-analysis to evaluate whether diverticulosis is associated with colorectal neoplasia. Methods A systematic literature search of PubMed, EMBASE, Cochrane Library, Web of Science, and SCOPUS was conducted to identify studies that investigated the association between diverticulosis and advanced colorectal neoplasia (advanced adenoma, colorectal cancer), adenomas, or polyps. The demographic characteristics of patients, including age, gender, indication for colonoscopy, confounding factors, and outcomes of colorectal neoplasia were assessed. Results We identified 29 cross-sectional studies (N = 450,953) that investigated the association between diverticulosis and colorectal neoplasia. The meta-analysis found that diverticulosis was not associated with advanced colorectal neoplasia (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.63-1.50). Although there was a positive correlation between diverticulosis and adenomas (OR 1.47, 95% CI 1.18-1.84) and diverticulosis and polyps (OR 1.95, 95% CI 1.15-3.31), diverticulosis did not increase the risk of adenomas (OR 1.34, 95% CI 0.87-2.06) in patients who underwent screening colonoscopy. Moreover, all the increased risk of colorectal neoplasia in patients with diverticulosis was observed in published studies only, and not in unpublished ones. Conclusions This meta-analysis demonstrated that diverticulosis is not associated with an increased risk of advanced colorectal neoplasia. Although diverticulosis was associated with a higher risk of polyps and adenomas, the risk was not increased in screening populations. Moreover, the increased risk of colorectal neoplasia in patients with diverticulosis was observed only in published studies and not in unpublished ones.

Original languageEnglish
Article numbere0216380
JournalPloS one
Volume14
Issue number5
DOIs
Publication statusPublished - 2019 May 1

Fingerprint

diverticulum
Diverticulum
meta-analysis
Meta-Analysis
neoplasms
adenoma
Neoplasms
Adenoma
odds ratio
confidence interval
Polyps
Screening
Odds Ratio
colonoscopy
Confidence Intervals
Colonoscopy
Library Science
screening
sociodemographic characteristics
colorectal neoplasms

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Lee, Hyun Jung ; Park, Soo Jung ; Cheon, JaeHee ; Kim, Tae Il ; Kim, Won Ho ; Kim, Hyun Jung. / The relationship between diverticulosis and colorectal neoplasia : A meta-analysis. In: PloS one. 2019 ; Vol. 14, No. 5.
@article{ba25f331515749f29914905012642ad7,
title = "The relationship between diverticulosis and colorectal neoplasia: A meta-analysis",
abstract = "Background/Aims Diverticulosis and colorectal neoplasia share epidemiological trends and risk factors which are common in Western countries and incidences increase with age. However, the data on an association between diverticulosis and colorectal neoplasia are conflicting. Thus, we performed a meta-analysis to evaluate whether diverticulosis is associated with colorectal neoplasia. Methods A systematic literature search of PubMed, EMBASE, Cochrane Library, Web of Science, and SCOPUS was conducted to identify studies that investigated the association between diverticulosis and advanced colorectal neoplasia (advanced adenoma, colorectal cancer), adenomas, or polyps. The demographic characteristics of patients, including age, gender, indication for colonoscopy, confounding factors, and outcomes of colorectal neoplasia were assessed. Results We identified 29 cross-sectional studies (N = 450,953) that investigated the association between diverticulosis and colorectal neoplasia. The meta-analysis found that diverticulosis was not associated with advanced colorectal neoplasia (odds ratio [OR] 0.98, 95{\%} confidence interval [CI] 0.63-1.50). Although there was a positive correlation between diverticulosis and adenomas (OR 1.47, 95{\%} CI 1.18-1.84) and diverticulosis and polyps (OR 1.95, 95{\%} CI 1.15-3.31), diverticulosis did not increase the risk of adenomas (OR 1.34, 95{\%} CI 0.87-2.06) in patients who underwent screening colonoscopy. Moreover, all the increased risk of colorectal neoplasia in patients with diverticulosis was observed in published studies only, and not in unpublished ones. Conclusions This meta-analysis demonstrated that diverticulosis is not associated with an increased risk of advanced colorectal neoplasia. Although diverticulosis was associated with a higher risk of polyps and adenomas, the risk was not increased in screening populations. Moreover, the increased risk of colorectal neoplasia in patients with diverticulosis was observed only in published studies and not in unpublished ones.",
author = "Lee, {Hyun Jung} and Park, {Soo Jung} and JaeHee Cheon and Kim, {Tae Il} and Kim, {Won Ho} and Kim, {Hyun Jung}",
year = "2019",
month = "5",
day = "1",
doi = "10.1371/journal.pone.0216380",
language = "English",
volume = "14",
journal = "PLoS One",
issn = "1932-6203",
publisher = "Public Library of Science",
number = "5",

}

The relationship between diverticulosis and colorectal neoplasia : A meta-analysis. / Lee, Hyun Jung; Park, Soo Jung; Cheon, JaeHee; Kim, Tae Il; Kim, Won Ho; Kim, Hyun Jung.

In: PloS one, Vol. 14, No. 5, e0216380, 01.05.2019.

Research output: Contribution to journalReview article

TY - JOUR

T1 - The relationship between diverticulosis and colorectal neoplasia

T2 - A meta-analysis

AU - Lee, Hyun Jung

AU - Park, Soo Jung

AU - Cheon, JaeHee

AU - Kim, Tae Il

AU - Kim, Won Ho

AU - Kim, Hyun Jung

PY - 2019/5/1

Y1 - 2019/5/1

N2 - Background/Aims Diverticulosis and colorectal neoplasia share epidemiological trends and risk factors which are common in Western countries and incidences increase with age. However, the data on an association between diverticulosis and colorectal neoplasia are conflicting. Thus, we performed a meta-analysis to evaluate whether diverticulosis is associated with colorectal neoplasia. Methods A systematic literature search of PubMed, EMBASE, Cochrane Library, Web of Science, and SCOPUS was conducted to identify studies that investigated the association between diverticulosis and advanced colorectal neoplasia (advanced adenoma, colorectal cancer), adenomas, or polyps. The demographic characteristics of patients, including age, gender, indication for colonoscopy, confounding factors, and outcomes of colorectal neoplasia were assessed. Results We identified 29 cross-sectional studies (N = 450,953) that investigated the association between diverticulosis and colorectal neoplasia. The meta-analysis found that diverticulosis was not associated with advanced colorectal neoplasia (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.63-1.50). Although there was a positive correlation between diverticulosis and adenomas (OR 1.47, 95% CI 1.18-1.84) and diverticulosis and polyps (OR 1.95, 95% CI 1.15-3.31), diverticulosis did not increase the risk of adenomas (OR 1.34, 95% CI 0.87-2.06) in patients who underwent screening colonoscopy. Moreover, all the increased risk of colorectal neoplasia in patients with diverticulosis was observed in published studies only, and not in unpublished ones. Conclusions This meta-analysis demonstrated that diverticulosis is not associated with an increased risk of advanced colorectal neoplasia. Although diverticulosis was associated with a higher risk of polyps and adenomas, the risk was not increased in screening populations. Moreover, the increased risk of colorectal neoplasia in patients with diverticulosis was observed only in published studies and not in unpublished ones.

AB - Background/Aims Diverticulosis and colorectal neoplasia share epidemiological trends and risk factors which are common in Western countries and incidences increase with age. However, the data on an association between diverticulosis and colorectal neoplasia are conflicting. Thus, we performed a meta-analysis to evaluate whether diverticulosis is associated with colorectal neoplasia. Methods A systematic literature search of PubMed, EMBASE, Cochrane Library, Web of Science, and SCOPUS was conducted to identify studies that investigated the association between diverticulosis and advanced colorectal neoplasia (advanced adenoma, colorectal cancer), adenomas, or polyps. The demographic characteristics of patients, including age, gender, indication for colonoscopy, confounding factors, and outcomes of colorectal neoplasia were assessed. Results We identified 29 cross-sectional studies (N = 450,953) that investigated the association between diverticulosis and colorectal neoplasia. The meta-analysis found that diverticulosis was not associated with advanced colorectal neoplasia (odds ratio [OR] 0.98, 95% confidence interval [CI] 0.63-1.50). Although there was a positive correlation between diverticulosis and adenomas (OR 1.47, 95% CI 1.18-1.84) and diverticulosis and polyps (OR 1.95, 95% CI 1.15-3.31), diverticulosis did not increase the risk of adenomas (OR 1.34, 95% CI 0.87-2.06) in patients who underwent screening colonoscopy. Moreover, all the increased risk of colorectal neoplasia in patients with diverticulosis was observed in published studies only, and not in unpublished ones. Conclusions This meta-analysis demonstrated that diverticulosis is not associated with an increased risk of advanced colorectal neoplasia. Although diverticulosis was associated with a higher risk of polyps and adenomas, the risk was not increased in screening populations. Moreover, the increased risk of colorectal neoplasia in patients with diverticulosis was observed only in published studies and not in unpublished ones.

UR - http://www.scopus.com/inward/record.url?scp=85066433140&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85066433140&partnerID=8YFLogxK

U2 - 10.1371/journal.pone.0216380

DO - 10.1371/journal.pone.0216380

M3 - Review article

VL - 14

JO - PLoS One

JF - PLoS One

SN - 1932-6203

IS - 5

M1 - e0216380

ER -