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CRC Risks Similar to General Population After Bariatric Surgery

Standardized incidence ratio increased for individuals with obesity without bariatric surgery

THURSDAY, March 12, 2020 (HealthDay News) — Patients with obesity undergoing bariatric surgery have the same risk for colorectal cancer (CRC) as the general population, according to a study published online March 11 in JAMA Surgery.

Laurent Bailly, M.D., Ph.D., from the Université Côte d’Azur in Nice, France, and colleagues examined the correlation between bariatric surgery and CRC among individuals with obesity. Data were compared for 74,131 patients undergoing bariatric surgery and 971,217 with no bariatric surgery.

The researchers found that 13,052 incident CRCs and 63,649 colorectal benign polyps were diagnosed. The rate of CRC was 0.6 and 1.3 percent in the bariatric surgery and no-surgery cohorts, respectively. In the no-surgery cohort, 9,417 cases were expected versus 12,629 observed (standardized incidence ratio, 1.34; 95 percent confidence interval, 1.32 to 1.36). In the bariatric surgery cohort, 428 and 423 cases, respectively, were expected and observed, with a standardized incidence ratio of 1.0 (95 percent confidence interval, 0.90 to 1.09). In comparable operated versus nonoperated groups, the propensity score-matched hazard ratios were 0.68 (95 percent confidence interval, 0.60 to 0.77) for CRC and 0.56 (95 percent confidence interval, 0.53 to 0.59) for colorectal benign polyps.

“Future exploration of incident CRC risk must account for differences in study population (i.e., race/ethnicity and national origin), mechanistic variation in bariatric surgical type, and length of follow-up while also distinguishing between rectal and colon cancer before the case is settled,” write the authors of an accompanying editorial.

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