Left-Sided Diverticulosis is a Risk Factor for Distal Colon Polyps

BACKGROUND AND AIMS Previous small to mid-sized studies have found an inconsistent relationship between diverticulosis and colon polyps. We assessed the odds of polyps in patients with left-sided diverticulosis (LDV) compared to patients without LDV, and if a predilection for polyps in the distal co...

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Autores principales:	Shashank Sarvepalli, Pooja Lal, Afrin Kamal, Ari Garber, John McMichael, Gareth Morris-Stiff, John Vargo, Micheal Rothberg, Maged Rizk, Carol Burke
Formato:	article
Lenguaje:	EN
Publicado:	Shiraz University of Medical Sciences 2020
Materias:	adenomas colorectal cancer surveillance sessile serrated polyps sessile serrated polyps detection rate adenoma detection rate Medicine R
Acceso en línea:	https://doaj.org/article/98dfa56b90434d1990cb71ae9a70a622
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spelling	oai:doaj.org-article:98dfa56b90434d1990cb71ae9a70a6222021-11-14T08:12:06ZLeft-Sided Diverticulosis is a Risk Factor for Distal Colon Polyps2783-243010.30476/acrr.2020.46438https://doaj.org/article/98dfa56b90434d1990cb71ae9a70a6222020-03-01T00:00:00Zhttps://colorectalresearch.sums.ac.ir/article_46438_99c38c079e7561a13b01e8a3557f361e.pdfhttps://doaj.org/toc/2783-2430BACKGROUND AND AIMS Previous small to mid-sized studies have found an inconsistent relationship between diverticulosis and colon polyps. We assessed the odds of polyps in patients with left-sided diverticulosis (LDV) compared to patients without LDV, and if a predilection for polyps in the distal colon (DC) versus the proximal colon (PC) existed. METHODS In this case-control, retrospective study records of all patients in the Cleveland Clinic undergoing average-risk, screening colonoscopy between January 2011-August 2017 were identified. Baseline characteristics were described. Multivariate logistic regression analysis was performed to identify odds of polyps in PC and DC after adjusting for clinical and colonoscopic factors. RESULTS 50,703 patients (mean age=60 years; 48% male) were included; 38.9% of patients had LDV. Compared to patients without LDV, those with LDV more often had adenomas (33.2% vs 27.8%; p <0.001), hyperplastic polyps (HPs) (18.3% vs 16.2%; p <0.001), and sessile serrated polyps (SSPs) (4.8% vs 4.3%; P=0.011). LDV was associated with adenomas in the DC (OR, 1.59; 95%CI, 1.52, 1.67) more than the PC (OR, 1.15; 95%CI, 1.10, 1.21), with HPs equally in the PC (OR, 1.27; 95%CI, 1.20, 1.34) and DC (OR, 1.28; 95%CI, 1.19, 1.38), and with SSPs in the DC only (OR, 1.50; 95%CI, 1.34, 1.67). CONCLUSIONS LDV is associated with a significantly increased risk of adenomas, HPs, and SSPs, but the association was stronger for adenomas in the DC. Careful inspection of the DC should be encouraged in patients with LDV. More research is needed to understand this phenomenon.Shashank SarvepalliPooja LalAfrin KamalAri GarberJohn McMichaelGareth Morris-StiffJohn VargoMicheal RothbergMaged RizkCarol BurkeShiraz University of Medical Sciencesarticleadenomascolorectal cancer surveillancesessile serrated polypssessile serrated polyps detection rateadenoma detection rateMedicineRENIranian Journal of Colorectal Research, Vol 8, Iss 1, Pp 1-8 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	adenomas colorectal cancer surveillance sessile serrated polyps sessile serrated polyps detection rate adenoma detection rate Medicine R
spellingShingle	adenomas colorectal cancer surveillance sessile serrated polyps sessile serrated polyps detection rate adenoma detection rate Medicine R Shashank Sarvepalli Pooja Lal Afrin Kamal Ari Garber John McMichael Gareth Morris-Stiff John Vargo Micheal Rothberg Maged Rizk Carol Burke Left-Sided Diverticulosis is a Risk Factor for Distal Colon Polyps
description	BACKGROUND AND AIMS Previous small to mid-sized studies have found an inconsistent relationship between diverticulosis and colon polyps. We assessed the odds of polyps in patients with left-sided diverticulosis (LDV) compared to patients without LDV, and if a predilection for polyps in the distal colon (DC) versus the proximal colon (PC) existed. METHODS In this case-control, retrospective study records of all patients in the Cleveland Clinic undergoing average-risk, screening colonoscopy between January 2011-August 2017 were identified. Baseline characteristics were described. Multivariate logistic regression analysis was performed to identify odds of polyps in PC and DC after adjusting for clinical and colonoscopic factors. RESULTS 50,703 patients (mean age=60 years; 48% male) were included; 38.9% of patients had LDV. Compared to patients without LDV, those with LDV more often had adenomas (33.2% vs 27.8%; p <0.001), hyperplastic polyps (HPs) (18.3% vs 16.2%; p <0.001), and sessile serrated polyps (SSPs) (4.8% vs 4.3%; P=0.011). LDV was associated with adenomas in the DC (OR, 1.59; 95%CI, 1.52, 1.67) more than the PC (OR, 1.15; 95%CI, 1.10, 1.21), with HPs equally in the PC (OR, 1.27; 95%CI, 1.20, 1.34) and DC (OR, 1.28; 95%CI, 1.19, 1.38), and with SSPs in the DC only (OR, 1.50; 95%CI, 1.34, 1.67). CONCLUSIONS LDV is associated with a significantly increased risk of adenomas, HPs, and SSPs, but the association was stronger for adenomas in the DC. Careful inspection of the DC should be encouraged in patients with LDV. More research is needed to understand this phenomenon.
format	article
author	Shashank Sarvepalli Pooja Lal Afrin Kamal Ari Garber John McMichael Gareth Morris-Stiff John Vargo Micheal Rothberg Maged Rizk Carol Burke
author_facet	Shashank Sarvepalli Pooja Lal Afrin Kamal Ari Garber John McMichael Gareth Morris-Stiff John Vargo Micheal Rothberg Maged Rizk Carol Burke
author_sort	Shashank Sarvepalli
title	Left-Sided Diverticulosis is a Risk Factor for Distal Colon Polyps
title_short	Left-Sided Diverticulosis is a Risk Factor for Distal Colon Polyps
title_full	Left-Sided Diverticulosis is a Risk Factor for Distal Colon Polyps
title_fullStr	Left-Sided Diverticulosis is a Risk Factor for Distal Colon Polyps
title_full_unstemmed	Left-Sided Diverticulosis is a Risk Factor for Distal Colon Polyps
title_sort	left-sided diverticulosis is a risk factor for distal colon polyps
publisher	Shiraz University of Medical Sciences
publishDate	2020
url	https://doaj.org/article/98dfa56b90434d1990cb71ae9a70a622
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Left-Sided Diverticulosis is a Risk Factor for Distal Colon Polyps

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