S665 Racial and Gender Differences in Adenoma Detection in Routine Colonoscopy After Acute Diverticulitis

Introduction: Colonic diverticulitis occurs when colonic outpouchings (diverticula) become inflamed. Symptoms include fever, abdominal pain, and hematochezia. Guidelines recommend follow-up colonoscopy 6–8 weeks post-acute diverticulitis to rule out colorectal cancer (CRC). Data on follow-up outcomes by race and gender remain limited. This study evaluates differences in adenoma detection by race and gender to reassess risk stratification in vulnerable populations. Methods: A retrospective cohort study reviewed clinical data from 550 patients treated at a tertiary center for acute diverticulitis between Jan 1, 2021 and Jul 31, 2024. Adults (≥18 years) who had post-diverticulitis colonoscopy or sigmoidoscopy were included. Patients without follow-up endoscopy or with prior CRC unrelated to diverticulitis were excluded. Data collected included demographics, comorbidities, BMI, social/family history, medication use, and colonoscopy findings. Primary outcomes were detection rates of CRC, advanced adenomas (AA), and non-advanced adenomatous polyps (NAP). AA were defined as ≥1 cm polyps, villous or tubulovillous histology, or dysplasia. Timing of colonoscopy relative to the 6–8 week window was analyzed. Statistical methods were primarily descriptive, including frequencies and proportions. Results: Of 550 patients, 113 (20.5%) underwent follow-up colonoscopy. Among them: 4.4% had CRC, 6.2% AA, and 23.9% NAP. Breakdown: 10 Black men, 11 Black women, 31 White men, 59 White women, and 2 non-Black/non-White patients. NAP rates: Black men 20%, Black women 27.3%, White men 22.6%, White women 22.0%. AA: Black women 18.2%, White men and women 9.7%, Black men 0%. CRC: White men 9.8%, White women 3.4%. Conclusion: Although diverticulitis is more common in women over 50, CRC detection post-diverticulitis was higher in White men. High AA rates in Black women suggest further investigation is needed. While debate continues over the necessity of follow-up colonoscopy after diverticulitis, more studies are needed to identify high-risk groups for CRC.