Does Bariatric Surgery Increase or Reduce Colorectal Cancer Risk—Is the Jury Still Out?
Menée en France à partir de données portant sur 1 045 348 personnes souffrant d'obésité et dont 74 131 ont subi une opération de chirurgie bariatrique (âge moyen : 57,3 ans ; durée moyenne de suivi : au moins 5,5 ans), cette étude analyse l'association entre cette chirurgie et le risque de cancer colorectal (13 052 cas)
In this issue of JAMA Surgery, Bailly et al report on the association of incident colorectal cancer (CRC) risk with bariatric surgery in a large sample of surgical and nonsurgical patients from the French National Health Insurance Information System. Using multivariable propensity score matching, they report a hazard ratio (HR) of 0.68 (95% CI, 0.60-0.77) for CRC when comparing patients undergoing bariatric surgery with matched nonsurgical patients. When the expected-to-observed CRC rates in the bariatric surgery group and matched nonsurgical patients were compared with the general population, the standardized incidence ratios (SIRs) were 1.0 (95% CI, 0.90-1.09) and 1.34 (95% CI, 1.32-1.36), respectively. The authors concluded that while nonsurgery patients with severe obesity had a 34% greater risk for incident CRC compared with the general population, patients undergoing bariatric surgery had an incident risk the same as the general population and a 32% lower incident CRC compared with matched nonsurgical patients.