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The rare epidemiologic coincidence of diverticular disease and advanced colonic neoplasia

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Abstract

Background and aims

In Western industrialised countries the prevalence of neoplastic colonic lesions and diverticular disease markedly increases with age. In contrast, the coincident occurrence of both diseases seems to fall below their individual epidemiologic estimates. Because directly comparing data are rare, this retrospective study evaluates the coincidence of neoplastic lesions and diverticular disease.

Patient and methods

A total of 1,838 patients from 1986 to 2000 were admitted to the study. For 1,326 patients—56% male (n=741), 44% female (n=585), mean age 64 (±11.83 SD)—with a resection due to colonic cancer, the documented findings of colonoscopy, colonic contrast enema, and/or histopathology were analysed with regard to the prevalence of colonic diverticulosis. In 512 patients—51% male (n=263), 49% female (n=249), mean age 60 (±12.59 SD)—with a colonic resection due to diverticulitis, the synchronous or metachronous occurrence of neoplastic colonic lesions was recorded using the database of the Tumour Centre, Aachen. To compare the observed results with published epidemiology, statistical analysis included age-referred binomial tests and an age-stratified analysis (Cochran–Mantel–Haenszel test). Odds ratios (OR) were also calculated. P<0.05 was considered to indicate locally statistical significance.

Results

In the cancer group, we found a statistically significant reduced rate of diverticula in nearly all age categories and the age-stratified analyses (corresponding OR 0.30–0.51). Consistently, the diverticulitis group revealed a statistically significant decreased rate of advanced colonic neoplastic lesion in nearly all age categories and all age-stratified analyses (corresponding OR 0.13–0.43).

Conclusion

Our results indicate that patients with colonic neoplastic lesions or diverticular disease probably form heterogeneous groups. Because current results from molecular biology emphasize the impact of the extracellular matrix on the genesis of diverticulosis and colonic cancer, the observed heterogeneity could be an expression of a distinct composition of the local milieu.

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Authors and Affiliations

  1. Surgical Department, Medical College, Rhenish-Westfalian Technical University, Aachen Pauwelsstr. 30, 52074, Aachen, Germany

    C. J. Krones, U. Klinge, N. Butz, K. Junge, M. Stumpf, R. Rosch & V. Schumpelick

  2. Institute of Pathology, Rhenish-Westfalian Technical University, Aachen, Germany

    B. Hermanns

  3. Institute of Medical Statistics, Rhenish-Westfalian Technical University, Aachen, Germany

    N. Heussen

Authors
  1. C. J. Krones
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  2. U. Klinge
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  3. N. Butz
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  4. K. Junge
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  5. M. Stumpf
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  6. R. Rosch
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  7. B. Hermanns
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  8. N. Heussen
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  9. V. Schumpelick
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Corresponding author

Correspondence to C. J. Krones.

Additional information

*The first two authors have contributed equally to the basic and clinical science presented.

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Krones, C.J., Klinge, U., Butz, N. et al. The rare epidemiologic coincidence of diverticular disease and advanced colonic neoplasia. Int J Colorectal Dis 21, 18–24 (2006). https://doi.org/10.1007/s00384-005-0742-5

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  • DOI: https://doi.org/10.1007/s00384-005-0742-5

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