Role of bariatric surgery in reducing the risk of colorectal cancer: a meta-analysis
A partir d'une recherche systématique de la littérature publiée jusqu'en décembre 2018 (7 articles ; 1 213 727 patients), cette méta-analyse évalue l'effet d'une chirurgie bariatrique sur le risque de développer un cancer colorectal chez les personnes obèses
Background : Obesity increases the risk of multiple co-morbidities such as type 2 diabetes, cardiovascular disease and most cancers, including colorectal cancer. Currently, the literature presents conflicting results regarding the protective effects of bariatric surgery on the incidence of colorectal cancer. This meta-analysis was conducted to investigate the effect of bariatric surgery on the risk of developing colorectal cancer in obese individuals. Methods : Ovid Embase, Ovid MEDLINE, Cochrane CENTRAL and Web of Science were searched for relevant articles. Articles published by the end of December 2018 were retrieved; data were extracted according to evidence-based PICO (population, intervention, control, outcome) model and analysed using a random-effects model to estimate the pooled relative risk (RR) and its 95 per cent confidence interval. The heterogeneity of studies was tested and quantified using Cochran's Q and I2 statistics. Meta-regression was used to investigate the association of year of study, region, mean length of follow-up and sample size with RR. Results : Seven articles, involving a total of 1 213 727 patients, were included in the meta-analysis. The pooled estimate of the RR was 0·64 (95 per cent c.i. 0·42 to 0·98). The test of asymmetry found no significant publication bias. Meta-regression showed that sample size was a statistically significant factor (P = 0·037), but year of publication, region and mean duration of follow-up were not significant. Conclusion : Patients who underwent bariatric surgery had a greater than 35 per cent reduction in the risk of developing colorectal cancer compared with obese individuals who had no surgery.