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Study Title and Description

Do we need colonoscopy following acute diverticulitis detected on computed tomography to exclude colorectal malignancy?



Key Questions Addressed
3 KQ 3: What are the benefits and harms of colonoscopy (or other colon imaging test) following an episode of acute diverticulitis? KQ 3a. What is the incidence of malignant and premalignant colon tumors found by colonoscopy, and what is the incidence of colon cancer mortality among patients undergoing screening? KQ 3b. What are the procedure-related and other harms of colonoscopy or CT colonography? KQ 3c. What is the frequency of inadequate imaging due to intolerance or technical feasibility? • Do the benefits and harms vary by patient characteristics, course of illness, or other factors?
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Primary Publication Information
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TitleData
Title Do we need colonoscopy following acute diverticulitis detected on computed tomography to exclude colorectal malignancy?
Author Choi YH., Koh SJ., Kim JW., Kim BG., Lee KL., Im JP., Kim JS., Jung HC.
Country Department of Internal Medicine, Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro Jongno-gu, Seoul, 110-744, Korea, crzyzs@naver.com.
Year 2014
Numbers Pubmed ID: 24723071

Secondary Publication Information
There are currently no secondary publications defined for this study.


Extraction Form: KQ 3: Colonoscopy
Arms
Number Title Description Comments
1 Diverticulitis with colonoscopy
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2 Healthy controls For each diverticulitis case, two age- (±5 years) and sex matched control individuals were identified from among healthy individuals who underwent screening colonoscopy
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3 Diverticulitis without colonoscopy
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Design Details
Question... Follow Up Answer Follow-up Answer
Study design NRCS (diverticulitis vs. healthy)
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NRCS (diverticulitis vs. healthy)
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NRCS (diverticulitis vs. healthy)
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NRCS (diverticulitis vs. healthy)
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if not an RCT, what was the directionality? Retrospective
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Funder Not reported (or unclear)
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Start and end years of the study 2001
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2013
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Inclusion criteria underwent CT, followed by colonoscopy within a year and diagnosed with acute diverticulitis. For each diverticulitis case, two age- (±5 years) and sex matched control individuals were identified from among healthy individuals who underwent screening colonoscopy.
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Exclusion criteria colorectal cancer, colorectal surgery, underwent colonoscopy 1 year prior to the diagnosis of diverticulitis.
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Specific population? No (anyone with Hx diverticulitis)
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No (anyone with Hx diverticulitis)
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No (anyone with Hx diverticulitis)
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No (anyone with Hx diverticulitis)
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Note/Comment about Design (or overall study)
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Country S Korea
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Comparison of colonoscopy vs. no colonoscopy? Yes
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Comparison of diverticulitis vs health control? Yes
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Subgroup analyses? R vs L sided
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R vs L sided
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Baseline Characteristics
Question Diverticulitis with colonoscopy Healthy controls Diverticulitis without colonoscopy Total Comments
AnswerFollow-up AnswerFollow-up AnswerFollow-up AnswerFollow-up
Participant race/ethnicity characteristics Male 59.7 Male 59.9
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Participant age, continuous 48.6 46.6
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16.5 16.6
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Age >=50, % No data entered.
Participants with Un/Complicated Diverticulitis Complicated diverticulitis 14.1 Complicated diverticulitis 8.2
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Uncomplicated diverticulitis 85.9 Uncomplicated diverticulitis 91.8
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Note/Comment about baseline characteristics No data entered.
Alarm symptoms No data entered.



Results & Comparisons


Results Data
Odds Ratio (OR) 95% CI low 95% CI high P-Value
Outcome: Colorectal cancer      Population: All Participants Between-Arm Comparisons
Time Point Measure Diverticulitis with colonoscopy Healthy controls Diverticulitis without colonoscopy Comparison Measure Diverticulitis with colonoscopy vs. Healthy controls


Enter a numeric value or title (required) years

N Analyzed 149 298 11.80
Counts 11 2 2.58
Percentage 7.4 0.7 53.95
0.001
Outcome: Colorectal cancer      Population: Diverticulitis on the left side colon
Time Point Measure Diverticulitis with colonoscopy Healthy controls Diverticulitis without colonoscopy


Enter a numeric value or title (required) years

N Analyzed 23
Counts 3
Percentage 13 [1]
P between subgroups 0.679 (left vs right)
Footnotes
1. p- value for the different between left and right diverticulitis is 0.679
Outcome: Colorectal cancer      Population: Diverticulitis on the right side colon
Time Point Measure Diverticulitis with colonoscopy Healthy controls Diverticulitis without colonoscopy


Enter a numeric value or title (required) years

N Analyzed 126
Counts 9
Percentage 7.1
Odds Ratio (OR) 95% CI low 95% CI high P-Value
Outcome: Advanced Colonic Neoplasia      Population: All Participants Between-Arm Comparisons
Time Point Measure Diverticulitis with colonoscopy Healthy controls Diverticulitis without colonoscopy Comparison Measure Diverticulitis with colonoscopy vs. Healthy controls


Enter a numeric value or title (required) years

N Analyzed 149 298 8.84
Counts 16 4 2.90
Percentage 10.7 1.3 26.96
<0.001
Outcome: Advanced Colonic Neoplasia      Population: Diverticulitis on the left side of colon
Time Point Measure Diverticulitis with colonoscopy Healthy controls Diverticulitis without colonoscopy


Enter a numeric value or title (required) years

N Analyzed 23
Counts 3
Percentage 13 [1]
P between subgroups 0.715 (left vs right)
Footnotes
1. p value for the difference between left and right diverticulitis is 0.715
Outcome: Advanced Colonic Neoplasia      Population: Diverticulitis on the right side of colon
Time Point Measure Diverticulitis with colonoscopy Healthy controls Diverticulitis without colonoscopy


Enter a numeric value or title (required) years

N Analyzed 126
Counts 13
Percentage 10.3
Odds Ratio (OR) 95% CI low 95% CI high P-Value
Outcome: Advance Adenoma      Population: All Participants Between-Arm Comparisons
Time Point Measure Diverticulitis with colonoscopy Healthy controls Diverticulitis without colonoscopy Comparison Measure Diverticulitis with colonoscopy vs. Healthy controls


Enter a numeric value or title (required) years

N Analyzed 149 298 5.14
Counts 5 2 0.99
Percentage 3.4 0.7 26.81
0.052
Outcome: Advance Adenoma      Population: Diverticulitis on the left side of colon
Time Point Measure Diverticulitis with colonoscopy Healthy controls Diverticulitis without colonoscopy


Enter a numeric value or title (required) years

N Analyzed 23
Counts 1
Percentage 4.3 [1]
P between subgroups 0.052 (left vs right)
Footnotes
1. p-value for the difference between left and right diverticulitis is 0.052
Outcome: Advance Adenoma      Population: Diverticulitis on the right side of colon
Time Point Measure Diverticulitis with colonoscopy Healthy controls Diverticulitis without colonoscopy


Enter a numeric value or title (required) years

N Analyzed 126
Counts 4
Percentage 3.2


Quality Dimensions
Dimension Value Notes Comments
Q23: NHLBI - Were eligibility/selection criteria for the study population prespecified and clearly described? Yes
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Q25: NHLBI - Were the outcome measures prespecified, clearly defined, valid, reliable, and assessed consistently across all study participants? Yes
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If this study was an NRCS or a single-group study, did the study report adjusted results that were for differences between groups (in the case of NRCSs) or differences between subgroups (in the case of single group studies)? Yes
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Quality Rating
No quality rating data was found.