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Impact of bariatric surgery on early-onset colorectal cancer risk: a systematic review and meta-analysis

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Abstract

The aim of this meta-analysis is to determine the impact of bariatric surgery on the risk of early-onset colorectal neoplasia. This systematic review was conducted according to PRISMA recommendations. It was registered in the PROSPERO international database. A comprehensive search was conducted in electronic databases (MEDLINE, EMBASE, and Web of Science) for completed studies until May 2022. The Search was made using a mixture of indexed terms and title, abstract and keywords. The search included terms: obese, surgical weight loss intervention, colorectal cancer, and colorectal adenomas. Studies that included bariatric intervention patient’s vs non-surgical obese patients younger than 50 years were considered. Inclusion criteria were patients with BMI more than 35 kg/m2 who underwent a colonoscopy. Studies with follow-up colonoscopy performed in less than 4 years after bariatric surgery and those that evaluated patients with a mean age difference of 5 or more years between groups were excluded. Outcomes analyzed in obese patients with surgical treatment vs control patients included colorectal cancer incidence. From 2008 to 2021, a total of 1536 records were identified. Five retrospective studies that included 48,916 patients were analyzed. Follow-up period ranged from 5 to 22.2 years. 20,663 (42.24%) patients underwent bariatric surgery and 28,253 (57.76%) were part of the control patients. Roux-en-Y gastric bypass was performed in 14,400 (69.7%) individuals. The intervention and control group were similar in age range, proportion of female participants and initial body mass index (35–48.3 vs 35–49.3, respectively). 126/20663 (0.61%) patients in the bariatric surgery group and 175/28253 (0.62%) individuals in the control group presented CRC. In this meta-analysis, we were unable to demonstrate a significant impact of the Bariatric Surgery on EOCRC risk. Prospective trials with longer follow-up periods should be done to prove the colorectal cancer risk reduction.

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Authors and Affiliations

  1. Surgical Health Outcomes Consortium (SHOC), Adventhealth Medical Group Colorectal Surgery, 2415 North Orange Av. Office 102., AdventHealth, Orlando, FL, USA

    L. Bustamante-Lopez, M. Sulbaran, N. R. Changoor, Y. Tilahun, N. Garcia-Henriquez, M. Albert, M. Soliman, J. R. T. Monson & Julie Pepe

  2. Mayo Clinic, Division of Gastroenterology and Hepatology, Jacksonville, FL, USA

    M. Sulbaran

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  1. L. Bustamante-Lopez
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  2. M. Sulbaran
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  3. N. R. Changoor
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  4. Y. Tilahun
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  5. N. Garcia-Henriquez
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  6. M. Albert
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  9. Julie Pepe
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Correspondence to L. Bustamante-Lopez.

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Bustamante-Lopez, L., Sulbaran, M., Changoor, N.R. et al. Impact of bariatric surgery on early-onset colorectal cancer risk: a systematic review and meta-analysis. Updates Surg 75, 1051–1057 (2023). https://doi.org/10.1007/s13304-023-01527-2

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  • DOI: https://doi.org/10.1007/s13304-023-01527-2

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