Bariatric surgery is tied to lower CRC risk

  • Bailly L & al.
  • JAMA Surg
  • 11 Mar 2020

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • A French study shows that bariatric surgery is associated with lowered colorectal cancer (CRC) risk consistent with the general population.

Why this matters

  • Previous studies have shown mixed results, but they had fewer CRC cases and generally younger populations.

Study design

  • Retrospective study based on French electronic health data of individuals with obesity (N=1,045,348; age, 50-75 years; 74,131 underwent bariatric surgery).
  • Funding: None disclosed.

Key results

  • During follow-up, the CRC rate was 1.2%, and 63,649 colorectal benign polyps were found.
  • 0.6% of the surgical cohort developed CRC compared with 1.3% of the nonsurgery cohort (P<.001>
  • In the nonsurgery cohort:
    • 9417 cases were expected, but 12,629 were observed.
    • Standardized incidence ratio, 1.34 (95% CI, 1.32-1.36).
  • In the surgical cohort:
    • 428 cases were expected based on the general French population, and 423 were observed.
    • Standardized incidence ratio, 1.0 (95% CI, 0.90-1.09).
  • Propensity-score matched analysis found reduced risk in surgical patients for:
    • CRC: HR, 0.68 (95% CI, 0.60-0.77).
    • Colorectal benign polyp: HR, 0.56 (95% CI, 0.53-0.59).
  • Compared with adjust gastric banding, gastric bypass and sleeve gastrectomy were associated with lower incidence of:
    • CRC: 0.5% for each vs 0.7% (P=.04).
    • Colorectal benign polyps: 3.1% for each vs 5.0% (P<.001>

Limitations

  • Retrospective analysis.