title: Risk of colorectal adenomas, advanced adenomas and cancer in patients with colonic diverticular disease: Systematic review and meta-analysis.
abstract: OBJECTIVE
  Diverticular disease and colorectal neoplasia are common digestive disorders worldwide. Both diseases share epidemiological trends and certain risk factors including advancing age, physical inactivity, and Western diet and lifestyle. Studies assessing the association between these diseases reported inconsistent results. Thus, we conducted a systematic review and meta-analysis to determine the association between diverticular disease and colorectal adenomas, advanced adenomas and cancer.
  
  
  METHODS
  A comprehensive search of the databases MEDLINE and EMBASE was done from inception through March 2016. Inclusion criterion was the observational studies' assessment of the association between diverticular disease and colorectal neoplasia in adult participants. Pooled OR and 95% confidence interval (CI) were calculated using a random effect.
  
  
  RESULTS
  Data were extracted from 14 observational studies (11 cross-sectional studies, one case-control study and two cohort studies). Diverticular disease was associated with increased odds of adenomas (OR = 1.67, 95% CI 1.27-2.21, 10 studies), but not associated with advanced adenomas (OR = 1.19, 95% CI 0.88-1.62, I2= 52%, four studies) or colorectal cancer (OR = 1.36, 95% CI 0.47-3.92, I2= 98%, seven studies).
  
  
  CONCLUSIONS
  Our meta-analysis demonstrated that diverticular disease was associated with colorectal adenomas. Colonoscopists should be aware of this association and carefully examine the entire large bowel in individuals with diverticulosis.
authors.affiliation: Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.|Department of Internal Medicine, University of Hawaii, Honolulu, USA.
authors.forename: Veeravich
authors.initials: V
authors.lastname: Jaruvongvanich
authors.affiliation: Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.|Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, USA.
authors.forename: Anawin
authors.initials: A
authors.lastname: Sanguankeo
authors.affiliation: Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, USA.
authors.forename: Karn
authors.initials: K
authors.lastname: Wijarnpreecha
authors.affiliation: Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.|Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, USA.
authors.forename: Sikarin
authors.initials: S
authors.lastname: Upala
mesh_terms: D000236:Adenoma / Q000453:epidemiology / Q000209:etiology*; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000209:etiology*; D004241:Diverticulum, Colon / Q000150:complications* / Q000453:epidemiology; D014943:Global Health; D006801:Humans; D015994:Incidence; D018570:Risk Assessment; D012307:Risk Factors
keywords: colorectal adenoma; colorectal cancer; colorectal neoplasm; diverticular disease; meta-analysis