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Cancer risk in patients with diverticular disease: A nationwide cohort study
Massachusetts Gen Hosp, Clin & Translat Epidemiol Unit, Boston, MA 02114 USA.;Massachusetts Gen Hosp, Div Gastroenterol, Boston, MA 02114 USA..ORCID iD: 0000-0001-9894-7072
Univ Newcastle, Coll Hlth Med & Wellbeing, Fac Hlth & Med, Dept Anat Pathol, Newcastle, NSW, Australia..
Statisticon AB, Uppsala, Sweden..
Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden..
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2023 (English)In: Journal of the National Cancer Institute, ISSN 0027-8874, E-ISSN 1460-2105, Vol. 115, no 1, p. 62-70Article in journal (Refereed) Published
Abstract [en]

Background There are little data on diverticular disease and cancer development other than colorectal cancer. Methods We conducted a population-based, matched cohort study with linkage of nationwide registers to the Epidemiology Strengthened by histoPathology Reports in Sweden histopathology cohort. We included 75 704 patients with a diagnosis of diverticular disease and colorectal histopathology and 313 480 reference individuals from the general population matched on age, sex, calendar year, and county. Cox proportional hazards models estimated multivariable-adjusted hazard ratios (HRs) for associations between diverticular disease and overall cancer and specific cancers. Results Over a median follow-up of 6 years, we documented 12 846 incident cancers among patients with diverticular disease and 43 354 incident cancers among reference individuals from the general population. Compared with reference individuals, patients with diverticular disease had statistically significantly increased overall cancer incidence (24.5 vs 18.1 per 1000 person-years), equivalent to 1 extra cancer case in 16 individuals with diverticular disease followed-up for 10 years. After adjusting for covariates, having a diagnosis of diverticular disease was associated with a 33% increased risk of overall cancer (95% confidence interval [CI] = 1.31 to 1.36). The risk increases also persisted compared with siblings as secondary comparators (HR = 1.26, 95% CI = 1.21 to 1.32). Patients with diverticular disease also had an increased risk of specific cancers, including colon cancer (HR = 1.71, 95% CI = 1.60 to 1.82), liver cancer (HR = 1.72, 95% CI = 1.41 to 2.10), pancreatic cancer (HR = 1.62, 95% CI = 1.42 to 1.84), and lung cancer (HR = 1.50, 95% CI = 1.39 to 1.61). The increase in colorectal cancer risk was primarily restricted to the first year of follow-up, and especially early cancer stages. Conclusions Patients with diverticular disease who have colorectal histopathology have an increased risk of overall incident cancer.

Place, publisher, year, edition, pages
Oxford University Press, 2023. Vol. 115, no 1, p. 62-70
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Cancer and Oncology Gastroenterology and Hepatology
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URN: urn:nbn:se:uu:diva-497356DOI: 10.1093/jnci/djac190ISI: 000883165400001PubMedID: 36200887OAI: oai:DiVA.org:uu-497356DiVA, id: diva2:1740353
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Swedish Cancer SocietyAvailable from: 2023-03-01 Created: 2023-03-01 Last updated: 2025-02-11Bibliographically approved

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Sköldberg, Filip

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