Bariatric surgery reduces colorectal cancer incidence in obese individuals: Systematic review and meta-analysis

doi:10.4240/wjgs.v15.i10.2331

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World Journal of Gastrointestinal Surgery

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Meta-Analysis

World J Gastrointest Surg. Oct 27, 2023; 15(10): 2331-2342
Published online Oct 27, 2023. doi: 10.4240/wjgs.v15.i10.2331

Bariatric surgery reduces colorectal cancer incidence in obese individuals: Systematic review and meta-analysis

Ying-Ning Liu, Jing-Feng Gu, Jian Zhang, Dong-Yang Xing, Gui-Qi Wang

Ying-Ning Liu, Jing-Feng Gu, Jian Zhang, Dong-Yang Xing, Gui-Qi Wang, Department of Gastrointestinal Surgery, The First Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China

Author contributions: Liu YN and Gu JF contributed to the conception of the study; Zhang J and Liu YN contributed significantly to literature search, data extraction, quality assessment, data analyses and manuscript preparation; Xing DY contributed improving the article for language and style and protocol preparation; Gu JF helped perform the analysis with constructive discussions; Wang GQ revised the manuscript and approved the final version.

Conflict-of-interest statement: The authors Ying-Ning Liu, Jing-Feng Gu, Jian Zhang, Dong-Yang Xing and Gui-Qi Wang all declare that there are no conflicts of interest related to this study.

PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.

Corresponding author: Gui-Qi Wang, MM, Chief Doctor, Department of Gastrointestinal Surgery, The First Hospital of Hebei Medical University, No. 89 Donggang Road, Shijiazhuang 050011, Hebei Province, China. doc_wangguiqi@163.com

Received: July 9, 2023
Peer-review started: July 9, 2023
First decision: August 10, 2023
Revised: August 14, 2023
Accepted: August 21, 2023
Article in press: August 21, 2023
Published online: October 27, 2023
Processing time: 110 Days and 1.6 Hours

Abstract

BACKGROUND

Colorectal cancer ranks third in global cancer prevalence and stands as the second leading cause of cancer-related mortalities. With obesity recognized as a pivotal risk factor for colorectal cancer, the potential protective role of bariatric surgery, especially laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy, has garnered attention.

AIM

To investigate the Roux-en-Y gastric bypass (RYGB) vs sleeve gastrectomy (SG) effect on colorectal cancer incidence in obese individuals.

METHODS

A systematic review and meta-analysis of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Seventeen studies with a total of 12497322 patients were included. The primary outcome was the relative risk (RR) of developing colorectal cancer in obese patients who underwent weight loss surgery compared to those who did not. Secondary outcomes included determining the RR for colon and rectal cancer separately and subgroup analyses by gender and type of weight loss surgery.

RESULTS

The meta-analysis revealed a 54% reduction in colorectal cancer risk in morbidly obese patients who underwent bariatric surgery compared to those who did not. A significant 46% reduction in colorectal cancer risk was observed among female patients. However, no significant differences were found in the meta-analysis for various types of bariatric surgery, such as SG and RYGB.

CONCLUSION

This meta-analysis reveals weight loss surgery, regardless of type, reduces colorectal cancer risk, especially in women, as indicated by RR and hazard ratio assessments. Further validation is essential.

Keywords: Obesity; Weight loss surgery; Colorectal cancer; Meta-analysis; Risk reduction

Core Tip: This comprehensive meta-analysis evaluates the impact of bariatric surgery on colorectal cancer (CRC) risk using 17 studies with over 12 million patients. Results show a 54% reduction in CRC risk after surgery, with women experiencing a 46% decrease. Interestingly, the type of bariatric surgery, whether Sleeve Gastrectomy or Roux-en-Y Gastric Bypass, did not influence this risk reduction. Bariatric procedures underscore a pivotal role in managing CRC risk in the obese. The study highlights the surgery's protective effect, especially for women, and the need for further research on potential confounding factors.