title: Epidemiology of diverticular disease -- systematic review of the literature.
abstract: BACKGROUND
  Associated with the Western diet and life style,diverticular disease is affecting more and more developing countries worldwide. Recent studies show an increase in incidence of the disease at young age, that raises the risk of complications, along with major consequences for the patient but also for the healthcare system.
  
  
  METHODS
  Systematic review of the literature with US National Library of Medicine and National Institutes of Health International PubMed Medline, using abstracts and articles available in PubMed Medline, Cochrane databases searching for ("Diverticulosis, Colonic epidemiology" [MeSH] OR"Diverticulosis, Colonic etiology" [MeSH] OR "Diverticulosis,Colonic genetics" [MeSH] OR "Diverticulosis, Colonic history" [MeSH]).
  
  
  RESULTS
  Even from the rise of diverticular disease as a public healthcare problem, at the end of the previous century, it was associated with a diet rich in refined sugars, lacking vegetable fibres. The higher incidence in countries like U.S.A., Canada, United Kingdom and the northern states compared with its rare occurrence in the sub-Saharan African continent, strengthen the anterior assumptions. In regions like Asia, the disease pattern is characterized by are latively low incidence of colonic diverticular disease, with distribution of diverticula mainly on the right colon. The different incidence by sex and age show the possible existence of hormonal protective factors. Studies from countries with a rich ethnic diversity, bring into question the probable genetic predisposition to diverticular disease, fact backed-up by the few studies on twins and 1st degree relatives available in the literature.
  
  
  CONCLUSIONS
  The rising incidence of colonic diverticular disease in Romania makes our country adhere the epidemiologic model existing in countries with a close socio-economic status.Although with a lower incidence than countries that have adopted a Western diet, Romania is likely to encounter a public health problem, if certain measures to identify and minimise the population exposure to risk factors are not taken.
authors: I
authors: I
authors: Tănase
authors: S
authors: S
authors: Păun
authors: B
authors: B
authors: Stoica
authors: I
authors: I
authors: Negoi
authors: B
authors: B
authors: Gaspar
authors: M
authors: M
authors: Beuran
mesh_terms: D017677:Age Distribution; D019049:Developed Countries; D003906:Developing Countries; D004032:Diet / Q000009:adverse effects; D004239:Diverticulitis, Colonic / Q000453:epidemiology; D043963:Diverticulosis, Colonic / Q000453:epidemiology* / Q000209:etiology; D004240:Diverticulum / Q000453:epidemiology*; D019317:Evidence-Based Medicine; D014943:Global Health; D006801:Humans; D015994:Incidence; D012307:Risk Factors; D012383:Romania / Q000453:epidemiology; D017678:Sex Distribution