The rate of diagnosis of underlying colorectal cancer (CRC) in individuals experiencing an episode of acute diverticulitis was found to be <1%, according to the results of a study published in the Journal of Gastrointestinal Cancer. Additionally, findings of CRC or polyps were associated with patient sex and were also predicted by the platelet-to-lymphocyte ratio.
Khoury and colleagues conducted the single-center, retrospective study to determine the prevalence of underlying CRC in a cohort of patients who experienced an episode of acute diverticulitis and underwent colonoscopy within 6 months at the EMMS Nazareth Hospital in Nazareth, Israel, between April 2014 and April 2018. The investigators also assessed the prognostic value of clinical and laboratory parameters for CRC diagnosis.
Data were collected from 225 patients (mean age ± SD, 55.73 ± 13.81; men/women, 61%/39%). Underlying CRC was detected in 0.89% (2/225) of the patients. Colonic polyps were identified in 7.56% (17/225) of patients. Colonoscopy was performed an average of 6 weeks after the episode of diverticulitis.
When grouping patients with and without CRC or polyps, 80% of the individuals with CRC or polyps were men compared with 60% in the group without findings (P = .039). Compared with patients with colonic polyps, patients with CRC were found to have elevated platelet count (353 x 103/μL vs 234 x 103/μL; P = .002) and platelet-to-lymphocyte ratio (223.65 vs 127.4; P = .015).
Limitations of the study included its retrospective design and that it was conducted at a single site.
The authors concluded that additional prospective, multicenter studies are warranted to further investigate the prevalence of CRC in the context of acute diverticulitis.
“Additionally, we recommend examining the role of platelet to lymphocyte ratio as a predicting simple parameter for CRC in a larger prospective trial,” wrote the authors.
Khoury T, Mahamid M, Lubany A, et al. Underlying colorectal cancer was rarely detected after an episode of acute diverticulitis: a retrospective analysis of 225 patients. J Gastrointest Cancer. 2020;51(1):48-52. doi:10.1007/s12029-019-00202-3