Background

Metabolic surgery has become the most effective therapy for weight loss and resolving obesity-associated diseases in patients with severe obesity. Recent literature has focused on investigating the benefits of metabolic surgery on colorectal cancer patients. The objective of this systematic review is to identify the effect of metabolic surgery on the risk of developing colorectal cancer in populations with severe obesity.

Methods

A systematic review was conducted, on 13 manuscripts with 10,924,393 patients between 2006 and 2022. Patients were divided into a surgical cohort (591,916) and a non-surgical cohort (10,332,477). Data collection included demographics, comorbidities, on surgical and cancer variables. Pearson's correlation coefficient was used to assess correlations. A p-value of < 0.05 was considered statistically significant.

Results

The incidence of total cancer (0.0004) and colorectal cancer (0.0003) in the surgical cohort was inferior to that of the non-surgical cohort (0.0193 and 0.009). Statistically significant positive correlations in the surgical group include age (r:0.78, p:0.004) and gastric band procedure (r:0.96, p:<0.01). Meanwhile, age (r:0.76, p:0.007), alcohol consumption (r:0.97 p:0.007), and both females (r:0.73, p:0.005) and males (r:0.75, p:0.003) demonstrated a strong and statistically significant positive correlation in the nonsurgical cohort. No other variables were found to be statistically significant.

Conclusions

The incidence of colorectal cancer, although low, was shown to be decreased in those who underwent metabolic surgery. This is a key finding that can emphasize the role of colorectal cancer screening and prevention in specific populations. Further research is needed to understand the full effect of this association.