Is Colonoscopy Necessary After Acute Uncomplicated Diverticulitis?

Allan S. Brett, MD

A meta-analysis suggests a very low cancer detection rate.

Many clinicians believe that all patients with acute diverticulitis should undergo colonoscopy to rule out cancer after the episode has subsided. To determine whether evidence supports this practice, researchers performed a meta-analysis of 11 studies in which patients with radiologically confirmed diverticulitis underwent colonoscopy, most within several months after their episodes of diverticulitis.

Colorectal cancer was diagnosed in 22 of 1970 patients overall (1.1%). Eight studies classified diverticulitis cases as uncomplicated or complicated; of the 1575 patients in this subset of studies, 79 had complicated diverticulitis. Incidence of colorectal cancer was 0.3% in uncomplicated cases, but 7.6% in complicated cases (6 cancers in 79 patients).

Citation(s):

Sharma PV et al. Systematic review and meta-analysis of the role of routine colonic evaluation after radiologically confirmed acute diverticulitis. Ann Surg 2014 Feb; 259:263.