Award: Presidential Poster Award
Fangyuan Jin-Dominguez, MD1, Emad Mansoor, MD2, Mohannad Abou Saleh, MD3, Gerard Isenberg, MD, MBA4, Richard C. Wong, MD4, Gregory S. Cooper, MD2
1University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, OH; 2University Hospitals Cleveland Medical Center, Cleveland, OH; 3Cleveland Clinic Foundation, Cleveland, OH; 4University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH
Introduction: Prior studies show the incidence of colorectal cancer (CRC) after an episode of diverticulitis ranges from 0 to 7.4%. We sought to describe the prevalence of first-ever diverticulitis in the US between 2014 and 2019 and evaluated the prevalence of first-ever CRC post diverticulitis in the US between January 2014 and 2019 utilizing a large population based database.
Methods: We queried a commercial database (Explorys Inc, OH), an aggregate of EHR data from 26 major integrated healthcare systems in the US from 1999 to 2019. We identified an aggregated patient cohort with a diagnosis of “diverticulitis of large intestine” from 2014 to 2019 followed by “first-ever primary malignant neoplasm of cecum, ascending colon, transverse colon, descending colon, sigmoid colon and/or rectum”, at least 1 day after and within 6 months of diverticulitis, aged >18 years, based on Systemized Nomenclature of Medicine – Clinical Terms. We excluded patients with IBD, family and personal history of CRC. We calculated the prevalence of diverticulitis and CRC post diverticulitis overall and among different patient groups.
Results: Of the 31,441,890 individuals active in the database from 2014-2019, we identified 785,740 individuals with first-ever diverticulitis with an overall prevalence of 2.5%. The prevalence in male was 2.6%, females 2.4%, adults (age 18-65 years) 1.5%, senior ( >65 years) 5.5%, Caucasian 3.3%, African-American 2.3% and Asian 1.3% (Figure 1). Furthermore, 4,390 out of 785,740 individuals were diagnosed with CRC (first-ever) post diverticulitis with prevalence of 0.56% (Figure 2). In contrast, the prevalence of CRC without history of diverticulitis was 0.3%. Odds ratio (OR) of CRC post diverticulitis was 1.9 compared to individuals without diverticulitis (P< 0.0001). The risk of CRC post diverticulitis was higher in female (OR 2.04, P< 0.0001) vs male; African Americans (OR 2.16, P< 0.0001) vs Caucasians and Asians; adults (OR 2.36, P< 0.0001) than seniors (Figure 3).
Discussion: This is one of the largest population-based national studies that describes the epidemiology of diverticulitis and first-ever CRC post diverticulitis from 2014 to 2019. Prevalence of diverticulitis is higher in male, seniors, and Caucasians. Post diverticulitis, patients are twice as likely to be diagnosed with CRC. The risk of post diverticulitis CRC is higher in female, adults and African-Americans. Given the high burden of CRC, we advocate for screening for CRC after first occurrence of diverticulitis among adults.
Citation: Fangyuan Jin-Dominguez, MD; Emad Mansoor, MD; Mohannad Abou Saleh, MD; Gerard Isenberg, MD, MBA; Richard C. Wong, MD; Gregory S. Cooper, MD. P1033 - EPIDEMIOLOGY OF DIVERTICULITIS AND PREVALENCE OF FIRST-EVER COLORECTAL CANCER POST-DIVERTICULITIS IN ADULTS IN THE UNITED STATES BETWEEN 2014 AND 2019: A POPULATION-BASED NATIONAL STUDY. Program No. P1033. ACG 2019 Annual Scientific Meeting Abstracts. San Antonio, Texas: American College of Gastroenterology.