Jeremy Meyer1, Lorenzo A Orci2, Christophe Combescure3, Alexandre Balaphas2, Philippe Morel2, Nicolas C Buchs2, Frédéric Ris2. 1. Division of Digestive and Transplantation Surgery, University Hospitals of Geneva, Genève, Switzerland; Unit of Surgical Research, University of Geneva, Genève, Switzerland. Electronic address: jeremy.meyer@hcuge.ch. 2. Division of Digestive and Transplantation Surgery, University Hospitals of Geneva, Genève, Switzerland; Unit of Surgical Research, University of Geneva, Genève, Switzerland. 3. Division of Clinical Epidemiology, University Hospitals of Geneva, Genève, Switzerland.
Abstract
BACKGROUND & AIMS: We performed a systematic review and meta-analysis to assess the prevalence of colorectal cancer in patients with acute diverticulitis. METHODS: We searched MEDLINE from inception through November 2nd, 2017 for studies reporting the prevalence of colorectal cancer in patients with diverticulitis, identified based on the protocol CRD42017083272. This systematic review was conducted in accordance to the MOOSE guidelines. Pooled prevalence values were obtained by random effects models and robustness was tested by leave-one out sensitivity analyses. Heterogeneity was assessed using the Q-test and quantified based on I2 value. The critical appraisal of included studies was performed using the Newcastle-Ottawa scale. RESULTS: Our final analysis included 31 studies, comprising 50,445 patients. The pooled prevalence of colorectal cancer was 1.9% (95% CI, 1.5%-2.3%). Patients with complicated diverticulitis had a significantly higher risk for colorectal cancer (prevalence, 7.9%; 95% CI, 3.9%-15.3%) than patients with uncomplicated diverticulitis (prevalence, 1.3%; 95% CI, 0.1%-2%), corresponding to a pooled prevalence ratio of 6.7 (95% CI, 2.5-18.3). Subgroup analyses did not find significant difference in prevalence when separately pooling studies according to ranking on the Newcastle-Ottawa scale, geographical location or length of follow-up. Meta-regression did not find any association between age and colorectal cancer. Among patients who underwent endoscopy, the pooled prevalence of polyps was 22.7% (95% CI, 19.6%-26.0%), of advanced adenomas was 4.4% (95% CI, 3.4%-5.8%), of adenomas was 14.2% (95% CI, 11.7%-17.1%), and of hyperplastic polyps was 9.2% (95% CI, 7.6%-11.2%). CONCLUSION: In a meta-analysis of observational studies of patients with acute diverticulitis, we found the pooled prevalence of colorectal cancer to be 1.9%. The risk of colorectal cancer was significantly higher in patients with complicated diverticulitis than in patients with uncomplicated diverticulitis.
BACKGROUND & AIMS: We performed a systematic review and meta-analysis to assess the prevalence of colorectal cancer in patients with acute diverticulitis. METHODS: We searched MEDLINE from inception through November 2nd, 2017 for studies reporting the prevalence of colorectal cancer in patients with diverticulitis, identified based on the protocol CRD42017083272. This systematic review was conducted in accordance to the MOOSE guidelines. Pooled prevalence values were obtained by random effects models and robustness was tested by leave-one out sensitivity analyses. Heterogeneity was assessed using the Q-test and quantified based on I2 value. The critical appraisal of included studies was performed using the Newcastle-Ottawa scale. RESULTS: Our final analysis included 31 studies, comprising 50,445 patients. The pooled prevalence of colorectal cancer was 1.9% (95% CI, 1.5%-2.3%). Patients with complicated diverticulitis had a significantly higher risk for colorectal cancer (prevalence, 7.9%; 95% CI, 3.9%-15.3%) than patients with uncomplicated diverticulitis (prevalence, 1.3%; 95% CI, 0.1%-2%), corresponding to a pooled prevalence ratio of 6.7 (95% CI, 2.5-18.3). Subgroup analyses did not find significant difference in prevalence when separately pooling studies according to ranking on the Newcastle-Ottawa scale, geographical location or length of follow-up. Meta-regression did not find any association between age and colorectal cancer. Among patients who underwent endoscopy, the pooled prevalence of polyps was 22.7% (95% CI, 19.6%-26.0%), of advanced adenomas was 4.4% (95% CI, 3.4%-5.8%), of adenomas was 14.2% (95% CI, 11.7%-17.1%), and of hyperplastic polyps was 9.2% (95% CI, 7.6%-11.2%). CONCLUSION: In a meta-analysis of observational studies of patients with acute diverticulitis, we found the pooled prevalence of colorectal cancer to be 1.9%. The risk of colorectal cancer was significantly higher in patients with complicated diverticulitis than in patients with uncomplicated diverticulitis.
Authors: Andrew S Miller; Kathryn Boyce; Benjamin Box; Matthew D Clarke; Sarah E Duff; Niamh M Foley; Richard J Guy; Lisa H Massey; George Ramsay; Dominic A J Slade; James A Stephenson; Phil J Tozer; Danette Wright Journal: Colorectal Dis Date: 2021-02 Impact factor: 3.917
Authors: Paola Fugazzola; Marco Ceresoli; Federico Coccolini; Francesco Gabrielli; Alessandro Puzziello; Fabio Monzani; Bruno Amato; Gabriele Sganga; Massimo Sartelli; Francesco Menichetti; Gabriele Adolfo Puglisi; Dario Tartaglia; Paolo Carcoforo; Nicola Avenia; Yoram Kluger; Ciro Paolillo; Mauro Zago; Ari Leppäniemi; Matteo Tomasoni; Lorenzo Cobianchi; Francesca Dal Mas; Mario Improta; Ernest E Moore; Andrew B Peitzman; Michael Sugrue; Vanni Agnoletti; Gustavo P Fraga; Dieter G Weber; Dimitrios Damaskos; Fikri M Abu-Zidan; Imtiaz Wani; Andrew W Kirkpatrick; Manos Pikoulis; Nikolaos Pararas; Edward Tan; Richard Ten Broek; Ronald V Maier; R Justin Davies; Jeffry Kashuk; Vishal G Shelat; Alain Chicom Mefire; Goran Augustin; Stefano Magnone; Elia Poiasina; Belinda De Simone; Massimo Chiarugi; Walt Biffl; Gian Luca Baiocchi; Fausto Catena; Luca Ansaloni Journal: World J Emerg Surg Date: 2022-01-21 Impact factor: 5.469