Colorectal Cancer and Weight Loss Surgery

A possibility that dietary changes
may play some role.

Reprinted from Eating Disorders Review
May/June Volume 24, Number 3
©2013 Gürze Books

Does surgery for obesity increase the risk of developing colon cancer? Yes, say Swedish and British researchers. When the researchers evaluated data from more than 77,000 obese patients, they found the risk of developing colorectal cancer was twice as high among those who had gastric weight loss surgery as among the general population (Ann Surg.  2013; March 6 [Epub ahead of print]).  However, the researchers said results should not discourage severely obese patients from having gastric surgery.  The risk of colorectal cancer was 26% higher among obese patients who did not have surgery than in the general population.

Dr. Jesper Lagergren, of Kings College, London, and the British and Swedish researchers conducted their nationwide retrospective register-based cohort study in Sweden. Patients were divided into an obesity surgery cohort (15,095 patients) and an obesity but no surgery cohort (62,016) patients). The risk for developing colorectal cancer rose with the length of time after surgery. When the researchers looked only at patients who had surgery more than 10 years before the end of the study period, the risk was 200 times that of obese persons in the general population.

Thus, the authors concluded that obesity surgery seems to be linked to an increased risk of colorectal cancer over time. They suggest that surveillance with colonoscopy should be part of the long-time follow-up for the growing population of patients who undergo obesity surgery. While there is no clear answer to why obesity surgery might lead to the elevated risk of developing colon cancer; one possibility is that dietary changes after surgery, particularly increasing the protein content of the diet, could raise the risk, according to Dr. Lagergren.

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