Risk of Cancer in Patients with Diverticular Disease: A Population-based Cohort Study

Background and aims Several studies have investigated the association between diverticular disease (DD) and colorectal cancer. However, whether there is an association between DD and malignancies other than those in the colorectum remains uncertain. Methods For the 1978-2019 period, we conducted a nationwide, population-based cohort study using national Danish healthcare data. We followed DD patients for up to 20 years, beginning one year after the date of DD diagnosis until the first occurrence of incident cancer, emigration, death, 20 years of follow-up, or December 31st, 2019. We calculated cumulative incidence proportions of cancer and standardized incidence ratios (SIRs) comparing cancer incidence among DD patients with that in the general population. Results We identified 200,639 patients with DD, of whom 20,498 were diagnosed with cancer during the 1–20 years after their DD diagnosis. The SIRs were increased for most cancer sites except for those in the colorectum (SIR: 0.75 [95% CI: 0.72–0.78]). The highest SIRs were observed for cancers of the lung, bronchi, and trachea (SIR, 1.20; 95% CI: 1.15–1.24) and kidney (SIR, 1.27; 95% CI: 1.16–1.39). Conclusions Our findings show an increased long-term relative risk of cancer following a diagnosis of DD. These findings are likely due to prevalence of numerous risk factors in DD patients that confer an increased risk of cancer. The decreased relative risk of colorectal cancer might be explained by an increased likelihood of DD patients undergoing colonoscopy with polypectomy.