Patients with diverticular disease are more likely than the general population to develop a range of cancers, according to a registry study published in the Journal of the National Cancer Institute.

Patients with diverticular disease have an increased risk of lung, prostate, breast, hematologic, colorectal, gastric, liver, and pancreatic cancers, researchers found.

The researchers conducted a population-based study of 75,704 patients from Swedish registries who had a diagnosis of diverticular disease and colorectal histopathology. The researchers also evaluated data from 313,480 matched individuals from the general population and 60,956 siblings of the patients with diverticular disease. 


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At a median follow-up of 6 years, the incidence of any cancer was higher in the diverticular disease cohort than in the general population — 24.5 per 1000 person-years and 18.1 per 1000 person-years, respectively. 

In a multivariate analysis, patients with diverticular disease had a 33% increase in cancer risk compared with the general population (hazard ratio [HR], 1.33; 95% CI, 1.31-1.36).

The risk of cancer was highest in the first year of follow-up (HR, 2.27; 95% CI, 2.15-2.38), but the risk remained significantly elevated after 5 years (HR, 1.18; 95% CI, 1.14-1.22). The risk was similar between women and men.

Patients with diverticular disease had an increased risk of multiple cancer types, including:

  • Solid tumors (HR, 1.33; 95% CI, 1.30-1.36)
  • Hematologic cancers (HR, 1.34; 95% CI, 1.24-1.44)
  • Liver cancer (HR, 1.72; 95% CI, 1.41-2.10)
  • Pancreatic cancer (HR, 1.62; 95% CI, 1.42-1.84)
  • Lung cancer (HR, 1.50; 95% CI, 1.39-1.61)
  • Colorectal cancer (HR, 1.42; 95% CI, 1.34-1.49)
  • Lymphoproliferative cancers (HR, 1.24; 95% CI, 1.13-1.35)
  • Gastric cancer (HR, 1.18; 95% CI, 1.01-1.38)
  • Breast cancer (HR, 1.17; 95% CI, 1.10-1.24)
  • Prostate cancer (HR, 1.13; 95% CI, 1.07-1.19).

Patients with diverticular disease also had an increased risk of cancer when compared with their siblings who did not have diverticular disease. The incidence of cancer (per 1000 person-years) was 19.2 in the diverticular disease cohort and 14.4 in the sibling cohort (HR, 1.26; 95% CI, 1.21-1.32).

“Patients with diverticular disease who have colorectal histopathology have an increased risk of overall incident cancer,” the researchers concluded. “Given the prevalence of diverticular disease is high, these results highlight the need for awareness and preventive strategies, such as lifestyle modifications, for cancer . . . in patients with diverticular disease.” 

Disclosures: One study author declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.

Reference

Ma W, Walker MM, Thuresson M, et al. Cancer risk in patients with diverticular disease: A nationwide cohort study. J Natl Cancer Inst. Published online October 6, 2022. doi:10.1093/jnci/djac190