Colon Cancer and Diverticular Disease Association: a Case-Control Study
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ORIGINAL RESEARCH
Colon Cancer and Diverticular Disease Association: a Case-Control Study Maggie B. Kearney 1,2
&
Jeffrey M. Williams 3 & Mark H. Ebell 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To determine if there is an association between diverticular disease and colon cancer diagnoses with a secondary outcome of assessing other known risk factors for colon cancer. Colon cancer and diverticular disease have many shared symptoms and risk factors; the association between the two has been debated for many years. Methods 36 cases of colon cancer and 144 age- and sex-matched controls were identified from records at an outpatient endoscopy center in Georgia. These cases and controls then were subject to a retrospective chart review to obtain any known risk factor data points for both diverticular disease and colon cancer. A traditional conditional logistic regression and a stepwise conditional logistic regression model were used to analyze the data using significant data points (P < 0.05). Results The final stepwise model found that systolic blood pressure (aOR = 1.027, 95% CI = 1.001 to 1.053), history of polyps (aOR = 0.106, 95% CI = 0.029 to 0.387), exercise (aOR = 0.311, 95% CI = 0.029 to 0.387), and history of diverticular disease (aOR = 0.269, 95% CI = 0.091 to 0.795) were protective factors significantly associated with colon cancer. Conclusions Presence and history of the removal of colorectal polyps, presence or history of diverticular disease, and exercise pose as protective factors against development of colon cancer. Keywords Colon Cancer . Diverticular Disease . Colorectal Polyps . Screening . Protective Factors
Introduction Colorectal cancer is the third leading cancer-cause of death in the USA [1]. In addition, diverticular disease incidence is on the rise worldwide, causing increased healthcare costs internationally [2]. Recently, a well-conducted nationwide cohort study notated a significant difference (P < 0.001) in incidence of colon cancer in patients with diverticulitis (4.3%) than incidence of colon cancer a group without diverticulitis (2.3%) [3]. A recent meta-analysis of 14 observational studies showed that
* Maggie B. Kearney [email protected]; [email protected] 1
Present address: University of Georgia College of Public Health, 100 Foster Rd., Athens, GA 30606, USA
2
Mercer University School of Medicine, 1501 Mercer University Drive, Macon, GA 31207, USA
3
Athens Gastroenterology Association, 3320 Old Jefferson Rd., Athens, GA 30607, USA
diverticular disease was associated with increased odds of adenomas, but not associated with colorectal cancer (OR = 1.12, 95% CI = 0.57 to 2.18) or advanced adenomas. However, Jaruvongvanich et al. made this claim while the OR confidence interval crosses over one, which indicates there is a possibility there may be no association [4]. Both diverticular disease and colorectal cancer share several common risk factors: age, diet, physical activity, weight, tobacco use, alcoho
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