title: Routine screening for colon cancer after conservative treatment of diverticulitis.
abstract: OBJECTIVE
  It is generally advised to perform colonoscopy after conservatively treated diverticulitis because colon cancer may present itself with similar symptoms, laboratory and radiological results. With this study we investigated in what percentage of patients a malignancy was found by performing routine colonoscopy or radiologic imaging after a conservatively treated episode of diverticulitis, and whether this follow-up programme could be reserved for a selected group of patients.
  
  
  METHODS
  In our hospital, routine colonoscopy or, as a second choice, radiologic imaging has been standard practice over the last decade. We collected all colonoscopy and radiologic imaging results that were conducted of all 516 patients who were diagnosed with diverticulitis in this period.
  
  
  RESULTS
  Of those 516 patients, 378 had undergone colonoscopy, 45 radiologic imaging and 93 did not undergo any additional investigation. Eight cases of malignant neoplasia were found in those patients (2.1%), and an additional number of 40 adenomatous polyps (9.5%). Six out of 8 patients with colon cancer reported rectal blood loss, significant weight loss or persisting abdominal pain after being treated for diverticulitis.
  
  
  CONCLUSIONS
  In patients who were conservatively treated with routine colonoscopy or radiologic imaging for apparent diverticulitis, a malignant tumour was found in the colon in 2.1% of them. If only performed in patients reporting alarm symptoms, a case of colon cancer would be missed in only 0.5% of patients conservatively treated for diverticulitis. Therefore, screening for colon cancer after conservative treatment of diverticulitis is only indicated in symptomatic patients.
authors.affiliation: Department of Surgery, Rijnstate Hospital Arnhem, Arnhem, The Netherlands.
authors.forename: Pim J C
authors.initials: PJ
authors.lastname: Schout
authors.forename: Ernst Jan
authors.initials: EJ
authors.lastname: Spillenaar Bilgen
authors.forename: Marcel J M
authors.initials: MJ
authors.lastname: Groenen
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000236:Adenoma / Q000175:diagnosis*; D001466:Barium Sulfate; D003106:Colon / Q000000981:diagnostic imaging; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003287:Contrast Media; D004239:Diverticulitis, Colonic / Q000628:therapy; D055088:Early Detection of Cancer; D004733:Enema; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D012007:Rectum; D014057:Tomography, X-Ray Computed; D015431:Weight Loss
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate