Does Bariatric Surgery Reduce the Risk of Colorectal Cancer in Individuals with Morbid Obesity? A Systematic Review and Meta-Analysis

Chierici, Andrea; Amoretti, Paolo; Drai, Céline; Fatico, Serena De; Barrière, Jérôme; Schiavo, Luigi; Iannelli, Antonio

doi:10.3390/nu15020467

Cited by 12 publications

(6 citation statements)

References 41 publications

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“…Males also had lower odds of colorectal polyps compared to adults with persistent obesity. However, this finding in males does not conform with the epidemiological literature showing no change in CRC risk in males after bariatric surgery [13]. An explanation for a discrepancy between the risk of colorectal polyps and that of CRC in males after bariatric surgery compared to controls could be due to the lack of power or follow-up duration to detect a reduction of CRC in males.…”

Section: Discussioncontrasting

confidence: 91%

“…Our polyp data are consistent with accumulating evidence showing a lower risk of colorectal cancer in females undergoing bariatric surgery compared to controls with severe obesity [10][11][12][13]. Males also had lower odds of colorectal polyps compared to adults with persistent obesity.…”

Section: Discussionsupporting

confidence: 91%

“…Indeed, multiple studies investigated CRC after bariatric surgery. Yet, despite a suggested lower risk of CRC in females after bariatric surgery, prior epidemiological data do not confirm a reduction in CRC risk in males [10][11][12][13]. The lack of a response in males is despite a more pronounced weight loss than in females after bariatric surgery [14].…”

Section: Introductionmentioning

confidence: 99%

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The Risk of Colorectal Polyps after Weight Loss Therapy Versus Obesity: A Propensity-Matched Nationwide Cohort Study

Hussan,

McLaughlin,

Chiang

et al. 2023

Cancers

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Background: A fundamental understanding of the impact of bariatric surgery (BRS) on mechanisms of colorectal carcinogenesis is limited. For instance, studies report a reduced risk of colorectal cancer in females but not in males after BRS. We examined whether this sex-specific difference existed at the earlier polyp development stage. Methods: This retrospective cohort study included 281,417 adults from the 2012–2020 MarketScan database. We compared polyps rates on colonoscopy in four groups: post- vs. pre-BRS (treatment) to post- vs. pre-severe obesity (SO) diagnosis (control). We focused our main analysis on a propensity-matched sample that yielded a balanced distribution of covariates in our four groups (n = 9680 adults, 21.9% males). We also adjusted for important covariates. Results: Metabolic syndrome parameters improved after bariatric surgery and worsened after severe obesity diagnosis (p < 0.05). The rate of polyps was 46.7% at a median of 0.5 years pre-BRS and 47.9% at a median of 0.6 years pre-SO diagnosis. The polyps rate was 45.4% at a median (range) of 3.2 (1.0–8.5) years post-BRS. Conversely, 53.8% of adults had polyps at 3.0 (1.0–8.6) years post-SO. There was no change in the risk of colorectal polyps in males or females post- vs. pre-BRS. However, the risk of polyps was higher in males (OR = 1.32, 95% CI: 1.02–1.70) and females (OR = 1.29, 95% CI: 1.13–1.47) post- vs. pre-SO. When compared to the control group (SO), the odds ratios for colorectal polyps were lower for males and females after bariatric surgery (OR = 0.63, 95% CI: 0.44–0.90, and OR = 0.79, 95% CI: 0.66–0.96, respectively). Conclusions: Obesity is associated with an increased risk of colorectal polyps, an effect that is ameliorated after bariatric surgery. These data are relevant for studies investigating colorectal carcinogenesis mechanisms.

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Section: Discussioncontrasting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

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The Risk of Colorectal Polyps after Weight Loss Therapy Versus Obesity: A Propensity-Matched Nationwide Cohort Study

Hussan,

McLaughlin,

Chiang

et al. 2023

Cancers

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“…Our study illuminates the 46% CRC risk reduction in females, a perspective not central to Pararas et al 's research[ 36 ]. Chierici et al 's contributions were foundational in our inquiry[ 39 ]. We shed light on the global prevalence of CRC in relation to obesity.…”

Section: Discussionmentioning

confidence: 99%

Bariatric surgery reduces colorectal cancer incidence in obese individuals: Systematic review and meta-analysis

Liu,

Gu,

Zhang

et al. 2023

World J Gastrointest Surg

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Postcholecystectomy bile duct injury (BDI) remains a devastating iatrogenic complication that adversely impacts the quality of life with high healthcare costs. Despite a decrease in the incidence of laparoscopic cholecystectomy-related BDI, the absolute number remains high as cholecystectomy is a commonly performed surgical procedure. Open Roux-en-Y hepaticojejunostomy with meticulous surgical technique remains the gold standard surgical procedure with excellent long-term results in most patients. As with many hepatobiliary disorders, a minimally invasive approach has been recently explored to minimize access-related complications and improve postoperative recovery. Since patients with gallstone disease are often admitted for a minimally invasive cholecystectomy, laparoscopic and robotic approaches for repairing postcholecystectomy biliary stricture are attractive. While recent series have shown the feasibility and safety of minimally invasive post-cholecystectomy biliary stricture management, most are retrospective analyses with small sample sizes. Also, long-term follow-up is available only in a limited number of studies. The principles and technique of minimally invasive repair resemble open repair except for the extent of adhesiolysis and the suturing technique with continuous sutures commonly used in minimally invasive approaches. The robotic approach overcomes key limitations of laparoscopic surgery and has the potential to become the preferred minimally invasive approach for the repair of postcholecystectomy biliary stricture. Despite increasing use, lack of prospective studies and selection bias with available evidence precludes definitive conclusions regarding minimally invasive surgery for managing postcholecystectomy biliary stricture. High-volume prospective studies are required to confirm the initial promising outcomes with minimally invasive surgery.

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“…The protective effect persisted for subgroups of women (relative risk 0.54; P=0.0014) but not for men (0.74; P=0.2798). No differences were found between surgical procedures 87…”

Section: Metabolic/bariatric Surgery and Cancermentioning

confidence: 90%

Long term outcomes of metabolic/bariatric surgery in adults

Courcoulas,

Daigle,

Arterburn

2023

BMJ

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The prevalence of obesity continues to rise around the world, driving up the need for effective and durable treatments. The field of metabolic/bariatric surgery has grown rapidly in the past 25 years, with observational studies and randomized controlled trials investigating a broad range of long term outcomes. Metabolic/bariatric surgery results in durable and significant weight loss and improvements in comorbid conditions, including type 2 diabetes. Observational studies show that metabolic/bariatric surgery is associated with a lower incidence of cardiovascular events, cancer, and death. Weight regain is a risk in a fraction of patients, and an association exists between metabolic/bariatric surgery and an increased risk of developing substance and alcohol use disorders, suicidal ideation/attempts, and accidental death. Patients need lifelong follow-up to help to reduce the risk of these complications and other nutritional deficiencies. Different surgical procedures have important differences in risks and benefits, and a clear need exists for more long term research about less invasive and emerging procedures. Recent guidelines for the treatment of obesity and metabolic conditions have been updated to reflect this growth in knowledge, with an expansion of eligibility criteria, particularly people with type 2 diabetes and a body mass index between 30.0 and 34.9.

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Does Bariatric Surgery Reduce the Risk of Colorectal Cancer in Individuals with Morbid Obesity? A Systematic Review and Meta-Analysis

Cited by 12 publications

References 41 publications

The Risk of Colorectal Polyps after Weight Loss Therapy Versus Obesity: A Propensity-Matched Nationwide Cohort Study

The Risk of Colorectal Polyps after Weight Loss Therapy Versus Obesity: A Propensity-Matched Nationwide Cohort Study

Bariatric surgery reduces colorectal cancer incidence in obese individuals: Systematic review and meta-analysis

Long term outcomes of metabolic/bariatric surgery in adults

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