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Diverticular disease associated with increased risk of multiple cancers
A recent study published in the Journal of the National Cancer Institute found that patients with diverticular disease are more likely compared to the general population to develop a range of cancers, including colorectal cancer.
What is diverticular disease?
Diverticular disease, also called diverticulosis, is a condition that affects the wall of the colon (large intestine), causing the inner lining of the large intestine to be pushed out through weak points in the surrounding muscle, causing small pouches or bulges known as diverticula (singular: diverticulum) to form. Alone, diverticulosis does not cause any symptoms. Treatment usually is not necessary unless these small pouches become infected and inflamed, causing diverticulitis. Symptoms include:
- • Abdominal pain
- • Fever
- • Nausea
- • A change in bowel habits
- • Bloating
- • Constipation
- • Diarrhea
- • Gas
Diverticular disease and diverticulitis are diagnosed with a colonoscopy and sometimes a CT scan.
What causes diverticular disease and diverticulitis?
Diverticular disease and diverticulitis appear to be more common in people with a low-fibre diet. Fibre helps to make the stool softer, decreasing pressure on the colon wall. A high-fibre diet helps to decrease constipation, helping stool move through the GI tract more smoothly and easily. The prevalence of diverticular disease increases significantly with age, with about 50% of Canadians over the age of 80 developing the disease (Canadian Digestive Health Foundation, 2009).
In the study, researchers examined data from 75,704 patients from Swedish health registries who received a diagnosis of diverticular disease. They also evaluated data 313,480 matched individuals (i.e. people of similar age, location, sex, just without diverticular disease) from the general population as well as 60,956 siblings of patients with diverticular disease.
At an average follow-up of 6 years, the incidence of any cancer was higher among patients with diverticular disease compared to the general population, who experienced a 33% increased risk of developing any cancer. This risk was similar between men and women.
Take home message
The study findings show an association between diverticular disease and the increased risk for developing various cancers including colon cancer. Since constipation often contributes to the development of diverticula, it is important to get enough daily fibre (25g/day for women, 38g/day for men) to help minimize constipation. Drinking enough water (about 2L, or 8- 8 ounce glasses of water a day), doing regular exercise, and limiting red meat and processed and refined foods are other recommendations that can help minimize constipation, improve gastrointestinal health and help to lower the risk of developing both diverticular disease and cancer.