title: Diverticular disease as a risk factor for sigmoid colon adenomas.
abstract: BACKGROUND
  Diverticular disease and colorectal neoplasia share similar epidemiological features and risk factors.
  
  
  OBJECTIVE
  To evaluate a possible association between diverticular disease and both adenomas and colorectal cancer in patients undergoing total colonoscopy.
  
  
  METHODS
  Overall, 630 consecutive patients were recruited from the 3 Units. Inclusion criteria were age over 45 years and the performance of total colonoscopy. Demographic and clinical data were recorded. Adenomas were defined as advanced when their size was >1 cm in diameter, and/or the percentage of the villous component was >30% and/or high grade dysplasia was present.
  
  
  RESULTS
  At endoscopy, 291 (47%) out of 630 patients presented evidence of diverticular disease. Adenomas were found in 92 (31.9%) patients with diverticular disease and in 98 (28.9%) patients without [p=ns]. The prevalence of adenomas located in the sigmoid colon was significantly higher in patients with diverticula than in controls (64.1% vs 41.8%; p<0.05). Similarly, the detection of advanced adenomas located in the sigmoid colon was more likely in patients with diverticula than in controls (59.6% vs 37.5%; p<0.05). Colorectal cancer prevalence was similar in patients with and without diverticula (8.3% vs 7.1%; p=ns), and no difference was detected regarding site, between the two groups.
  
  
  CONCLUSIONS
  Patients with diverticular disease have a higher risk of harbouring adenomas and advanced adenomas in the sigmoid colon. This observation should be taken into account in screening and surveillance programmes for colorectal neoplasia.
authors.affiliation: Gastroenterology and Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy. s.morini@flashnet.it
authors.forename: S
authors.initials: S
authors.lastname: Morini
authors.forename: C
authors.initials: C
authors.lastname: Hassan
authors.forename: A
authors.initials: A
authors.lastname: Zullo
authors.forename: V
authors.initials: V
authors.lastname: De Francesco
authors.forename: V
authors.initials: V
authors.lastname: Festa
authors.forename: F
authors.initials: F
authors.lastname: Barberani
authors.forename: D
authors.initials: D
authors.lastname: Faleo
authors.forename: T
authors.initials: T
authors.lastname: Stroffolini
mesh_terms: D000236:Adenoma / Q000453:epidemiology / Q000209:etiology*; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000209:etiology*; D004241:Diverticulum, Colon / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D012810:Sigmoid Diseases / Q000150:complications*