AB030. SOH23ABS_142. 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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AB030. SOH23ABS_142. The impact of bariatric surgery on the incidence of colorectal cancer in patients with obesity—a systematic review and meta-analysis of registry data

Odhrán Ryan1, Matthew Davey2, Éanna Ryan1, Noel Donlon1, Ian Reynolds1, Naomi Fearon1, Seán Martin1, Helen Heneghan1

1Department of Surgery, St Vincent’s University Hospital, Elm Park, Dublin, Ireland; 2Discipline of Surgery, The Lambe Institute for Translational Research, National University of Ireland, Galway, Ireland

Background: Cancer and obesity represent two of the most significant global health concerns. The risk of malignancy, including colorectal cancer (CRC), increases with obesity. We aimed to determine the impact of bariatric surgery on CRC risk in patients with obesity using registry data.

Methods: A systematic review and metanalysis 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 (CI) using the Mantel-Haenszel method. A multi-treatment comparison was performed, examining the risk reduction associated with commonly performed bariatric surgery procedures. Analysis was performed using RevMan, R packages, and Shiny.

Results: Data from 11 registries including 6,214, 682 patients with obesity were analysed. Of these, 14.0% underwent bariatric surgery (n=872,499) and 86.0% did not undergo surgery (n=5,432,183). 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 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.

Conclusions: 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.

Keywords: Bariatric; colorectal; metabolic; obesity; surgery

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

doi: 10.21037/map-23-ab030
Cite this abstract as: Ryan O, Davey M, Ryan É, Donlon N, Reynolds I, Fearon N, Martin S, Heneghan H. AB030. SOH23ABS_142. The impact of bariatric surgery on the incidence of colorectal cancer in patients with obesity—a systematic review and meta-analysis of registry data. Mesentery Peritoneum 2023;7:AB030.

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