Skip to main content
Log in

Does Biliopancreatic Diversion Carry Increased Risk for Colorectal Cancer? A Cohort Study

  • Research Article
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

Because of the rearrangement of the gastrointestinal tract, biliopancreatic diversion (BPD) could lead to an increased risk of colorectal cancer caused by possible carcinogenetic action of the unabsorbed food and bile acid on colonic mucosa.

Methods

The incidence of colorectal cancer in 1,898 obese subjects submitted to BPD from May 76 to July 2002 with a minimum follow-up of 5 years was retrospectively evaluated.

Results

Among 28,811 person-years, seven cases of colorectal cancer were detected, for an overall incidence of 29.4 per 100,000, which is not different from that observed in the general Italian population, and lower than that reported for obese and type 2 diabetes patients. Logistic regression model suggests that occurrence of colorectal cancer is positively related to the time elapsed from BPD.

Conclusion

This study indicates that BPD does not carry any increased risk for colorectal cancer. The complete postoperative restoration of insulin sensibility could exert a valuable protective action.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Potter JD. Nutrition and colorectal cancer. Cancer Causes Control 1996;7:127–46.

    Article  PubMed  CAS  Google Scholar 

  2. Lipkin M, Reddy B, Newmark H, Lamprecht SA. Dietary factors in human colorectal cancer. Ann Rev Nutr 1999;19:545–86.

    Article  CAS  Google Scholar 

  3. Martinez ME, Giovannucci E. Diet and the prevention of cancer. Cancer Metastasis Rev 1997;16:357–76.

    Article  PubMed  CAS  Google Scholar 

  4. Harris DM, Go VL. Vitamin D and colon carcinogenesis. J Nutr 2004;134:3463S–71S.

    PubMed  CAS  Google Scholar 

  5. Martinez ME, Willett WC. Calcium, vitamin D, and colorectal cancer: a review of the epidemiologic evidence. Cancer Epidemiol Biomark Prev 1998;7:163–8.

    CAS  Google Scholar 

  6. Harris PJ, Ferguson LR. Dietary fibres may protect or enhance carcinogenesis. Mutat Res 1999;443:95–110.

    PubMed  CAS  Google Scholar 

  7. Chaplin MF. Bile acids, fibre and colon cancer: the story unfolds. J R Soc Health 1998;118:53–61.

    Article  PubMed  CAS  Google Scholar 

  8. Debruyne PR, Bruyneel EA, Li X, Zimber A, Gespach C, Mareel MM. The role of bile acids in carcinogenesis. Mutat Res 2001;480–481:359–69.

    PubMed  Google Scholar 

  9. Scopinaro N, Adami GF, Marinari GM, et al. Biliopancreatic diversion. World J Surg 1998;22:936–46.

    Article  PubMed  CAS  Google Scholar 

  10. Scopinaro N, Gianetta E, Civalleri D, et al. Biliopancreatic bypass. In: Griffen WO, Printen KJ, editors. Surgical management of obesity. Marcel Decker: New York and Basel; 1987. p. 93–161.

    Google Scholar 

  11. Moore LL, Bradlee ML, Singer MR, et al. BMI and waist circumference as predictors of lifetime colon cancer risk in Framingham Study. Int J Obes Relat Metab Disord 2004;28:559–67.

    Article  PubMed  CAS  Google Scholar 

  12. MacInnis RJ, English DR, Hopper JL, et al. Body size and composition and colon cancer risk in men. Cancer Epidemiol Biomark Prev 2004;13:553–9.

    Google Scholar 

  13. Giovannucci E, Michaud D. The role of obesity and related metabolic disturbances in cancers of the colon, prostate, and pancreas. Gastroenterology 2007;132:2208–25.

    Article  PubMed  CAS  Google Scholar 

  14. Larsson SC, Wolk A. Obesity and colon and rectal cancer risk: a meta-analysis of prospective studies. Am J Clin Nutr 2007;86:556–65.

    PubMed  CAS  Google Scholar 

  15. Adami GF, Cordera R, Camerini G, Marinari GM, Scopinaro N. Long-term normalization of insulin sensitivity following biliopancreatic diversion for obesity. Int J Obes Relat Metab Disord 2004;28:671–3.

    Article  PubMed  CAS  Google Scholar 

  16. Guidone C, Manco M, Valera-Mora E, et al. Mechanisms of recovery from type 2 diabetes after malabsorptive bariatric surgery. Diabetes 2006;55:2025–31.

    Article  PubMed  CAS  Google Scholar 

  17. Capocaccia R, De Angelis R, Frova L, et al. Estimation and projections of colorectal cancer trends in Italy. Int J Epidemiol 1997;26:924–32.

    Article  PubMed  CAS  Google Scholar 

  18. Hu FB, Manson JE, Liu S, et al. Prospective study of adult onset diabetes mellitus (type 2) and risk of colorectal cancer in women. J Natl Cancer Inst 1999;91:542–7.

    Article  PubMed  CAS  Google Scholar 

  19. Bray F, Sankila R, Ferlay J, Parkin DM. Estimates of cancer incidence and mortality in Europe in 1995. Eur J Cancer 2002;38:99–166.

    Article  PubMed  CAS  Google Scholar 

  20. Verdecchia A, Micheli A, Colonna M, Moreno V, Izarzugaza MI, Paci E; EUROPREVAL Working Group. A comparative analysis of cancer prevalence in cancer registry areas of France, Italy and Spain. Ann Oncol 2002;13:1128–39.

    Article  PubMed  CAS  Google Scholar 

  21. Ponz de Leon M, Marino M, Benatti P, et al. Trend of incidence, subsite distribution and staging of colorectal neoplasms in the 15-year experience of a specialised cancer registry. Ann Oncol 2004;15:940–6.

    Article  PubMed  CAS  Google Scholar 

  22. Adami GF, Papadia FS, Scopinaro N. Colorectal cancer after biliopancreatic diversion for obesity. Int J Obes (Lond) 2007 Dec;31(12):1864. Epub 2007 Jun 19.

    Google Scholar 

  23. Yang YX, Hennessy S, Lewis JD. Type 2 diabetes mellitus and the risk of colorectal cancer. Clin Gastroenterol Hepatol 2005;3:587–94.

    Article  PubMed  Google Scholar 

  24. Will JC, Galuska DA, Vinicor F, Calle EE. Colorectal cancer: another complication of diabetes mellitus? Am J Epidemiol 1998;147:816–25.

    PubMed  CAS  Google Scholar 

  25. Giovannucci E. Insulin and colon cancer. Cancer Causes Control 1995;6:164–79.

    Article  PubMed  CAS  Google Scholar 

  26. Giovannucci E. Insulin, insulin-like growth factors and colon cancer: a review of the evidence. J Nutr 2001;131:3109S–20S.

    PubMed  CAS  Google Scholar 

  27. McKeown-Eyssen G. Epidemiology of colorectal cancer revisited: are serum triglycerides and/or plasma glucose associated with risk? Cancer Epidemiol Biomark Prev 1994;3:687–95.

    CAS  Google Scholar 

  28. Scopinaro N, Marinari GM, Camerini GB, Papadia FS, Adami GF. Specific effects of biliopancreatic diversion on the major components of metabolic syndrome: a long-term follow-up study. Diabetes Care 2005;28(10):2406–11.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Gian Franco Adami.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Adami, G.F., Papadia, F.S., Marinari, G.M. et al. Does Biliopancreatic Diversion Carry Increased Risk for Colorectal Cancer? A Cohort Study. OBES SURG 18, 212–215 (2008). https://doi.org/10.1007/s11695-007-9348-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-007-9348-z

Keywords

Navigation