title: Colonoscopy after CT diagnosis of diverticulitis to exclude colon cancer: a systematic literature review.
abstract: OBJECTIVE
  To estimate the prevalence of underlying adenocarcinoma of the colon in patients in whom acute diverticulitis was diagnosed at computed tomography (CT) and to compare that to the prevalence of colon cancer in the general population.
  
  
  METHODS
  A comprehensive literature review was performed to find articles in which patients with CT diagnosis of acute diverticulitis underwent surgery, colonoscopy, or barium enema study within 24 weeks. Patients meeting these criteria were included for analysis. A pooled prevalence of cancer was calculated on the basis of a random effects model and compared qualitatively with the prevalence of cancer in the general population. The 95% confidence intervals around the prevalence of cancer in the study populations were determined.
  
  
  RESULTS
  Ten articles met the inclusion criteria. Data from these articles included only 771 patients who underwent surgery, colonoscopy, or barium enema study within 24 weeks of diagnosis. Fourteen patients were found to have colon cancer, for a prevalence of 2.1% (95% confidence interval: 1.2%, 3.2%). This compares to a calculated estimated prevalence of 0.68% among U.S. adults older than 55 years.
  
  
  CONCLUSIONS
  There are limited data to support the recommendation to perform colonoscopy after a diagnosis of acute diverticulitis.
authors.affiliation: Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA 94143, USA. victor.sai@ucsf.edu
authors.forename: Victor F
authors.initials: VF
authors.lastname: Sai
authors.forename: Fernando
authors.initials: F
authors.lastname: Velayos
authors.forename: John
authors.initials: J
authors.lastname: Neuhaus
authors.forename: Antonio C
authors.initials: AC
authors.lastname: Westphalen
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D001466:Barium Sulfate; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D003113:Colonoscopy; D016001:Confidence Intervals; D003287:Contrast Media; D003937:Diagnosis, Differential; D004239:Diverticulitis, Colonic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000453:epidemiology; D006801:Humans; D011237:Predictive Value of Tests; D015995:Prevalence; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate