Colonic diverticulosis is not a risk factor for colonic adenoma

Wandong Hong,1,2,* Lemei Dong,1,* Maddalena Zippi,3,* Simon Stock,4 Wujun Geng,5,* Chunfang Xu,2 Mengtao Zhou6 1Department of Gastroenterology and Hepatology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; 2Department of Gastroenterology, The First Affiliated Hospital, Soochow University, Suzhou, Jiangsu, China; 3Unit of Gastroenterology and Digestive Endoscopy, Sandro Pertini Hospital, Rome, Italy; 4Department of Surgery, World Mate Emergency Hospital, Battambang, Cambodia; 5Department of Anesthesiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China; 6Department of Surgery, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China *These authors contributed equally to this work Background and aims: Colonic diverticulosis may represent a risk factor for colonic adenomas by virtue of the fact that evolving data suggest that these 2 conditions may share common risk factors such as Western dietary pattern and physical inactivity. This study aims to investigate the association between colonic diverticulosis and colonic adenomas in mainland China. Methods: We conducted a cross-sectional study on patients who underwent colonoscopic examination between October 2013 and December 2014 in a university hospital in mainland China. Age, gender, colonic adenomas, advanced adenomas, and distribution of diverticulosis were recorded during the procedures. Multivariate logistic regression and stratified analysis were used to evaluate the associations between the prevalence of diverticulosis and age, sex, and presence of colonic adenomas and advanced adenomas. Results: A total of 17,456 subjects were enrolled. The prevalence of colonic diverticulosis and adenoma was 2.4% and 13.2%, respectively. With regard to distribution of diverticula, most (365/424, 86.1%) were right-sided. Multiple logistic regression analysis suggested that age and male gender were independent risk factors for adenoma and advanced adenoma. There was no relationship between diverticulosis or location of diverticulosis and presence of adenoma and advanced adenoma adjusting by age and gender. In a stratified analysis according to age and gender, similar results were also noted. Conclusion: There was no statistical relationship between diverticulosis and the risk of adenoma and advanced adenoma. Our results may not be generalized to the Western population due to the fact that left-sided diverticular cases were very small in our study. Keywords: colonic adenoma, advanced adenoma, colonic diverticulosis, prevalence, risk facto