Cancer and Advanced Adenoma Detection After Acute Diverticulitis: A Retrospective Cohort Study

Acute diverticulitis (AD) is characterized by the inflammation of one or more mucosal diverticula.Previous guidelines for AD included follow-up colonoscopy to detect cancer, but advancements in high-resolution computed tomography (CT) have challenged the importance of such colonoscopies in recent years.Complicated AD is thought to have a higher risk of being associated with colorectal cancer (CRC), and thus a follow-up colonoscopy is still recommended for these patients; however, for patients who do not experience complications, the lower risk of CRC, added healthcare costs, and risks for bowel perforation during colonoscopy may outweigh the benefits.This study aims to assess whether the number of follow-up colonoscopies for AD can be safely reduced without increasing the risk of missed cancer or adenoma in our population.To do this, we investigated the intraluminal findings of patients who underwent a follow-up colonoscopy after a CT-confirmed AD using a retrospective cohort study approach for patients who received their diagnosis at the Hôpital Montfort emergency department.A total of 146 patients were separated into either uncomplicated (n = 102) or complicated (n = 44) AD groups, with demographic and clinical data being collected from electronic medical records for statistical analyses.The studied patients had no instances of CRC found by colonoscopy, further supporting a more conservative use of follow-up colonoscopies for AD.As a result, we believe that healthcare professionals should consider individual risk assessments over a universal post-diverticulitis endoscopic examination policy.