A novel study from Henry Ford Hospital seems to question the need for aggressive screening for colonic polyps in patients suffering from diverticulosis. The study sought to determine if asymptomatic patients with diverticular disease may be at higher or lower risk for developing colonic polyps, abnormal growths found in the wall of the colon that sometimes turn into cancerous.
According to the National Digestive Diseases Information Clearing House, nearly 10 percent of Americans older than 40, and half of those over age 60 seem to have diverticulosis. Diverticulosis is known to be a condition where small pouches inside the lining of the colon bulge outward via weak spots. When the pouches become inflamed, the condition could result in bleeding, serious infections, small tears or blockages inside the colon.
For the purpose of the study, Henry Ford physicians examined approximately 1,668 patients who had undergone full colonoscopy. More so, these patients appear to have an average likelihood for colon cancer. The patients were categorized into two groups namely the case group and the control group. The case group was believed to have included 899 patients with diverticulosis whereas the control group comprised 769 patients without diverticular disease.
Colonic polyps and diverticulosis are known to be common conditions in Western countries. Also, both these diseases appear to share common influencing factors such as older age and low-fiber diet. However, it was believed that there is a conflicting data on the association between the presence of diverticulosis and colonic polyps.
“We found that patients with diverticulosis have a lower incidence of polyps overall and a tendency for less-advanced polyps. These results suggest that for patients with diverticulosis, a less-aggressive surveillance regimen could be appropriate,” says lead author of the study, Ali Nawras, M.D., chief of Endoscopy Services, Division of Gastroenterology at Henry Ford Hospital.
The study authors found that the incidence of polyps seems to be considerably lower in the case group i.e. 223 patients or 24% in contrast to the control group i.e. 336 patients, or 43%. Furthermore, a sub analysis for different polyp sizes and pathologies was observed to have been conducted too.
Polyps may be considered high-risk if they were greater than 1 cm in size, or had tubulo-villous or cancer pathology. Subjects with diverticulosis appear to have a significantly lower rate of high-risk polyps, i.e. 36 patients or 4.1%, as compared to those without diverticulosis i.e. 76 patients or 6.8%.
The findings of the study have been presented at the American College of Gastroenterology’s Annual Scientific Meeting in San Diego.