The impact of bariatric surgery on colorectal cancer risk
Obesity is considered a risk factor for different types of cancer, including colorectal cancer (CRC). Bariatric surgery has been associated with improvements in obesity-related co-morbidities and reductions in overall cancer risk. However, given the contradictory outcomes of several cohort studies,...
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Veröffentlicht in: | Surgery for obesity and related diseases 2023-02, Vol.19 (2), p.144-157 |
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description | Obesity is considered a risk factor for different types of cancer, including colorectal cancer (CRC). Bariatric surgery has been associated with improvements in obesity-related co-morbidities and reductions in overall cancer risk. However, given the contradictory outcomes of several cohort studies, the impact of bariatric surgery on CRC risk appears controversial. Furthermore, measurement of CRC biomarkers following Roux-en-Y gastric bypass (RYGB) has revealed hyperproliferation and increased pro-inflammatory gene expression in the rectal mucosa. The proposed mechanisms leading to increased CRC risk are alterations of the gut microbiota and exposure of the colorectum to high concentrations of bile acids, both of which are caused by RYGB-induced anatomical rearrangements. Studies in animals and humans have highlighted the similarities between RYGB-induced microbial profiles and the gut microbiota documented in CRC. Microbial alterations common to post-RYGB cases and CRC include the enrichment of pro-inflammatory microbes and reduction in butyrate-producing bacteria. Lower concentrations of butyrate following RYGB may also contribute to an increased risk of CRC, given the anti-inflammatory and anticarcinogenic properties of this molecule. Laparoscopic sleeve gastrectomy appears to have a more moderate impact than RYGB; however, relatively few animal and human studies have investigated its effects on CRC risk. Moreover, evidence regarding the impact of anastomosis gastric bypass on one is even more limited. Therefore, further studies are required to establish whether the potential increase in CRC risk is restricted to RYGB or may also be associated with other bariatric procedures.
•Cohort and biomarker studies suggest an increased risk of colorectal cancer following bariatric surgery.•Microbial alterations reported after Roux-en-Y gastric bypass are similar to those observed in patients with colorectal cancer.•Higher serum concentrations of bile acids and lower levels of butyrate following bariatric surgery could contribute to an increased risk of colorectal cancer. |
doi_str_mv | 10.1016/j.soard.2022.10.016 |
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•Cohort and biomarker studies suggest an increased risk of colorectal cancer following bariatric surgery.•Microbial alterations reported after Roux-en-Y gastric bypass are similar to those observed in patients with colorectal cancer.•Higher serum concentrations of bile acids and lower levels of butyrate following bariatric surgery could contribute to an increased risk of colorectal cancer.</description><identifier>ISSN: 1550-7289</identifier><identifier>EISSN: 1878-7533</identifier><identifier>DOI: 10.1016/j.soard.2022.10.016</identifier><identifier>PMID: 36446717</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Animals ; Bariatric surgery ; Bariatric Surgery - adverse effects ; Bile acids ; Colorectal cancer risk ; Colorectal Neoplasms - etiology ; Colorectal Neoplasms - surgery ; Gastrectomy - methods ; Gastric Bypass - methods ; Humans ; Microbiota ; Obesity - complications ; Obesity - surgery ; Obesity, Morbid - complications ; Obesity, Morbid - surgery ; Retrospective Studies ; Short-chain fatty acids</subject><ispartof>Surgery for obesity and related diseases, 2023-02, Vol.19 (2), p.144-157</ispartof><rights>2023 American Society for Metabolic and Bariatric Surgery</rights><rights>Copyright © 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c334t-67d2a05f09ec72cd8dfe21ba8be426c1dd6ce2c8da065bfead179ae47b951d1d3</citedby><cites>FETCH-LOGICAL-c334t-67d2a05f09ec72cd8dfe21ba8be426c1dd6ce2c8da065bfead179ae47b951d1d3</cites><orcidid>0000-0002-4398-1262</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.soard.2022.10.016$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36446717$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>D’Amato, Sara</creatorcontrib><creatorcontrib>Sofia, Maria</creatorcontrib><creatorcontrib>Agosta, Marcello</creatorcontrib><creatorcontrib>Litrico, Giorgia</creatorcontrib><creatorcontrib>Sarvà, Iacopo</creatorcontrib><creatorcontrib>La Greca, Gaetano</creatorcontrib><creatorcontrib>Latteri, Saverio</creatorcontrib><title>The impact of bariatric surgery on colorectal cancer risk</title><title>Surgery for obesity and related diseases</title><addtitle>Surg Obes Relat Dis</addtitle><description>Obesity is considered a risk factor for different types of cancer, including colorectal cancer (CRC). Bariatric surgery has been associated with improvements in obesity-related co-morbidities and reductions in overall cancer risk. However, given the contradictory outcomes of several cohort studies, the impact of bariatric surgery on CRC risk appears controversial. Furthermore, measurement of CRC biomarkers following Roux-en-Y gastric bypass (RYGB) has revealed hyperproliferation and increased pro-inflammatory gene expression in the rectal mucosa. The proposed mechanisms leading to increased CRC risk are alterations of the gut microbiota and exposure of the colorectum to high concentrations of bile acids, both of which are caused by RYGB-induced anatomical rearrangements. Studies in animals and humans have highlighted the similarities between RYGB-induced microbial profiles and the gut microbiota documented in CRC. Microbial alterations common to post-RYGB cases and CRC include the enrichment of pro-inflammatory microbes and reduction in butyrate-producing bacteria. Lower concentrations of butyrate following RYGB may also contribute to an increased risk of CRC, given the anti-inflammatory and anticarcinogenic properties of this molecule. Laparoscopic sleeve gastrectomy appears to have a more moderate impact than RYGB; however, relatively few animal and human studies have investigated its effects on CRC risk. Moreover, evidence regarding the impact of anastomosis gastric bypass on one is even more limited. Therefore, further studies are required to establish whether the potential increase in CRC risk is restricted to RYGB or may also be associated with other bariatric procedures.
•Cohort and biomarker studies suggest an increased risk of colorectal cancer following bariatric surgery.•Microbial alterations reported after Roux-en-Y gastric bypass are similar to those observed in patients with colorectal cancer.•Higher serum concentrations of bile acids and lower levels of butyrate following bariatric surgery could contribute to an increased risk of colorectal cancer.</description><subject>Animals</subject><subject>Bariatric surgery</subject><subject>Bariatric Surgery - adverse effects</subject><subject>Bile acids</subject><subject>Colorectal cancer risk</subject><subject>Colorectal Neoplasms - etiology</subject><subject>Colorectal Neoplasms - surgery</subject><subject>Gastrectomy - methods</subject><subject>Gastric Bypass - methods</subject><subject>Humans</subject><subject>Microbiota</subject><subject>Obesity - complications</subject><subject>Obesity - surgery</subject><subject>Obesity, Morbid - complications</subject><subject>Obesity, Morbid - surgery</subject><subject>Retrospective Studies</subject><subject>Short-chain fatty acids</subject><issn>1550-7289</issn><issn>1878-7533</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kEtPwzAQhC0EoqXwC5CQj1xS_Ijj5MABVbykSlzK2XLsDbgkdbETpP57HFo4ctrVaGZH-yF0ScmcElrcrOfR62DnjDCWlHnSjtCUlrLMpOD8OO1CkEyyspqgsxjXhPBCSHaKJrzI80JSOUXV6h2w67ba9Ng3uNbB6T44g-MQ3iDssN9g41sfwPS6xUZvDAQcXPw4RyeNbiNcHOYMvT7crxZP2fLl8Xlxt8wM53mfFdIyTURDKjCSGVvaBhitdVlDzgpDrS0MMFNaTQpRN6AtlZWGXNaVoJZaPkPX-7vb4D8HiL3qXDTQtnoDfoiKyZwLIimpkpXvrSb4GAM0ahtcp8NOUaJGZmqtfpipkdkoJi2lrg4FQ92B_cv8QkqG270B0ptfDoKKxkECYd2IRVnv_i34BvF0fso</recordid><startdate>202302</startdate><enddate>202302</enddate><creator>D’Amato, Sara</creator><creator>Sofia, Maria</creator><creator>Agosta, Marcello</creator><creator>Litrico, Giorgia</creator><creator>Sarvà, Iacopo</creator><creator>La Greca, Gaetano</creator><creator>Latteri, Saverio</creator><general>Elsevier Inc</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4398-1262</orcidid></search><sort><creationdate>202302</creationdate><title>The impact of bariatric surgery on colorectal cancer risk</title><author>D’Amato, Sara ; Sofia, Maria ; Agosta, Marcello ; Litrico, Giorgia ; Sarvà, Iacopo ; La Greca, Gaetano ; Latteri, Saverio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c334t-67d2a05f09ec72cd8dfe21ba8be426c1dd6ce2c8da065bfead179ae47b951d1d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Animals</topic><topic>Bariatric surgery</topic><topic>Bariatric Surgery - adverse effects</topic><topic>Bile acids</topic><topic>Colorectal cancer risk</topic><topic>Colorectal Neoplasms - etiology</topic><topic>Colorectal Neoplasms - surgery</topic><topic>Gastrectomy - methods</topic><topic>Gastric Bypass - methods</topic><topic>Humans</topic><topic>Microbiota</topic><topic>Obesity - complications</topic><topic>Obesity - surgery</topic><topic>Obesity, Morbid - complications</topic><topic>Obesity, Morbid - surgery</topic><topic>Retrospective Studies</topic><topic>Short-chain fatty acids</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>D’Amato, Sara</creatorcontrib><creatorcontrib>Sofia, Maria</creatorcontrib><creatorcontrib>Agosta, Marcello</creatorcontrib><creatorcontrib>Litrico, Giorgia</creatorcontrib><creatorcontrib>Sarvà, Iacopo</creatorcontrib><creatorcontrib>La Greca, Gaetano</creatorcontrib><creatorcontrib>Latteri, Saverio</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery for obesity and related diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>D’Amato, Sara</au><au>Sofia, Maria</au><au>Agosta, Marcello</au><au>Litrico, Giorgia</au><au>Sarvà, Iacopo</au><au>La Greca, Gaetano</au><au>Latteri, Saverio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of bariatric surgery on colorectal cancer risk</atitle><jtitle>Surgery for obesity and related diseases</jtitle><addtitle>Surg Obes Relat Dis</addtitle><date>2023-02</date><risdate>2023</risdate><volume>19</volume><issue>2</issue><spage>144</spage><epage>157</epage><pages>144-157</pages><issn>1550-7289</issn><eissn>1878-7533</eissn><abstract>Obesity is considered a risk factor for different types of cancer, including colorectal cancer (CRC). Bariatric surgery has been associated with improvements in obesity-related co-morbidities and reductions in overall cancer risk. However, given the contradictory outcomes of several cohort studies, the impact of bariatric surgery on CRC risk appears controversial. Furthermore, measurement of CRC biomarkers following Roux-en-Y gastric bypass (RYGB) has revealed hyperproliferation and increased pro-inflammatory gene expression in the rectal mucosa. The proposed mechanisms leading to increased CRC risk are alterations of the gut microbiota and exposure of the colorectum to high concentrations of bile acids, both of which are caused by RYGB-induced anatomical rearrangements. Studies in animals and humans have highlighted the similarities between RYGB-induced microbial profiles and the gut microbiota documented in CRC. Microbial alterations common to post-RYGB cases and CRC include the enrichment of pro-inflammatory microbes and reduction in butyrate-producing bacteria. Lower concentrations of butyrate following RYGB may also contribute to an increased risk of CRC, given the anti-inflammatory and anticarcinogenic properties of this molecule. Laparoscopic sleeve gastrectomy appears to have a more moderate impact than RYGB; however, relatively few animal and human studies have investigated its effects on CRC risk. Moreover, evidence regarding the impact of anastomosis gastric bypass on one is even more limited. Therefore, further studies are required to establish whether the potential increase in CRC risk is restricted to RYGB or may also be associated with other bariatric procedures.
•Cohort and biomarker studies suggest an increased risk of colorectal cancer following bariatric surgery.•Microbial alterations reported after Roux-en-Y gastric bypass are similar to those observed in patients with colorectal cancer.•Higher serum concentrations of bile acids and lower levels of butyrate following bariatric surgery could contribute to an increased risk of colorectal cancer.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>36446717</pmid><doi>10.1016/j.soard.2022.10.016</doi><tpages>14</tpages><orcidid>https://orcid.org/0000-0002-4398-1262</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Animals Bariatric surgery Bariatric Surgery - adverse effects Bile acids Colorectal cancer risk Colorectal Neoplasms - etiology Colorectal Neoplasms - surgery Gastrectomy - methods Gastric Bypass - methods Humans Microbiota Obesity - complications Obesity - surgery Obesity, Morbid - complications Obesity, Morbid - surgery Retrospective Studies Short-chain fatty acids |
title | The impact of bariatric surgery on colorectal cancer risk |
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