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The impact of bariatric surgery on the incidence of colorectal cancer in patients with obesity-a systematic review and meta-analysis of registry data.pdf (1.13 MB)

The impact of bariatric surgery on the incidence of colorectal cancer in patients with obesity - a systematic review and meta-analysis of registry data

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posted on 2023-07-19, 17:03 authored by Matthew G Davey, Odhrán K Ryan, Eanna RyanEanna Ryan, Noel E Donlon, Ian S Reynolds, Naomi M Fearon, Sean T Martin, Helen M Heneghan

Purpose: Cancer and obesity represent two of the most significant global health concerns. The risk of malignancy, including colorectal cancer (CRC), increases with obesity. The aim of this study was to perform a systematic review and meta-analysis to determine the value of bariatric surgery in reducing CRC risk in patients with obesity using registry data.

Materials and methods: A systematic review and meta-analysis were performed as per PRISMA guidelines. The risk of CRC was expressed as a dichotomous variable and reported as odds ratios (OR) with 95% confidence intervals (CIs) using the Mantel-Haenszel method. A multi-treatment comparison was performed, examining the risk reduction associated with existing bariatric surgery techniques. Analysis was performed using RevMan, R packages, and Shiny.

Results: Data from 11 registries including 6,214,682 patients with obesity were analyzed. Of these, 14.0% underwent bariatric surgery (872,499/6,214,682), and 86.0% did not undergo surgery (5,432,183/6,214,682). The mean age was 49.8 years, and mean follow-up was 5.1 years. In total, 0.6% of patients who underwent bariatric surgery developed CRC (4,843/872,499), as did 1.0% of unoperated patients with obesity (54,721/5,432,183). Patients with obesity who underwent bariatric surgery were less likely to develop CRC (OR: 0.53, 95% CI: 0.36-0.77, P < 0.001, I2 = 99%). Patients with obesity undergoing gastric bypass surgery (GB) (OR: 0.513, 95% CI: 0.336-0.818) and sleeve gastrectomy (SG) (OR: 0.484, 95% CI: 0.307-0.763) were less likely to develop CRC than unoperated patients.

Conclusion: At a population level, bariatric surgery is associated with reduced CRC risk in patients with obesity. GB and SG are associated with the most significant reduction in CRC risk.

Prospero registration: CRD42022313280.

Funding

Open Access funding provided by the IReL Consortium

History

Comments

The original article is available at https://link.springer.com/

Published Citation

Davey MG. et al. The impact of bariatric surgery on the incidence of colorectal cancer in patients with obesity - a systematic review and meta-analysis of registry data. Obes Surg. 2023;33(8):2293-2302

Publication Date

21 June 2023

PubMed ID

37341934

Department/Unit

  • Physiology and Medical Physics

Publisher

Springer Science + Business Media

Version

  • Published Version (Version of Record)