The Impact of Educational Status on the Occurrence of Colonic Diverticula: Insights from an Austrian Cohort Study

• Published in: Medical principles and practice Vol. 33; no. 3; pp. 242 - 250
• Main Authors: Völkerer, Andreas, Wernly, Sarah, Semmler, Georg, Flamm, Maria, Radzikowski, Konrad, Datz, Leonora, Aigner, Elmar, Datz, Christian, Wernly, Bernhard
• Format: Journal Article
• Language: English
• Published: Basel, Switzerland S. Karger AG 25.03.2024
• Subjects: Adult; Aged; Alcohol; Asymptomatic; Austria - epidemiology; Body mass index; Cohort Studies; Colonoscopy; Colonoscopy - statistics & numerical data; Colorectal cancer; Diabetes; Disease; Diverticulitis; Diverticulosis, Colonic - epidemiology; Diverticulum, Colon - epidemiology; Educational Status; Exercise; Fast food; Fatty liver; Female; Health behavior; Health care access; Higher education; Humans; Hypertension; Logistic Models; Male; Metabolic syndrome; Metabolic Syndrome - epidemiology; Middle Aged; Original Paper; Prevention; Questionnaires; Risk Factors; Sex Factors; Socioeconomic factors; Socioeconomic status; Variables; Austria; Diverticulosis; GISCED; Socioeconomic status; Educational status
• ISSN: 1011-7571; 1423-0151; 1423-0151
• DOI: 10.1159/000538308

Abstract Objective: Education often reflects socioeconomic status. Research indicates that lower socioeconomic status may increase the risk of diverticulosis, and according to data from the USA, diverticular disease is a significant and costly health problem. Our study explores the link between educational level and colonic diverticula occurrence. Subject and Methods: We conducted a cohort study on 5,532 asymptomatic Austrian patients who underwent colonoscopy, categorizing them by education level using the updated Generalized International Standard Classification of Education (GISCED). Logistic regression models, adjusting for age, gender, metabolic syndrome, diet, and activity, were used to determine the association between education and diverticulosis. Results: Overall, 39% of the patients had low educational status, while 53% had medium, and 8% had high educational status. Colon diverticula were less frequent in patients with medium (OR 0.73) and high (aOR 0.62) educational status. Medium educational level remained associated with lower rates of diverticulosis after adjustment for age and sex (aOR 0.85) and further metabolic syndrome, dietary habits, and physical activity (aOR 0.84). In higher education status, this phenomenon was only seen by trend. Conclusion: Low education correlated with higher colon diverticula risk, while medium education showed lower rates even after adjustments. This trend persisted at higher education levels, highlighting the potential for strategies for cost reduction tailored to socioeconomic conditions. Highlights of the StudyThis study on 5,532 Austrian patients who underwent colonoscopy found a link between education level (classified by the Generalized International Standard Classification of Education) and occurrence of colonic diverticula.Higher education correlated with lower diverticulosis rates, even after adjusting for factors like age, gender, and lifestyle.Tailored cost-reduction strategies could be developed based on socioeconomic status.