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Invited Commentary
March 11, 2020

Does Bariatric Surgery Increase or Reduce Colorectal Cancer Risk—Is the Jury Still Out?

Author Affiliations
  • 1Department of Exercise Sciences, Brigham Young University, Provo, Utah
  • 2Department of Internal Medicine, University of Utah, Salt Lake City
  • 3Intermountain Live Well Center, Intermountain Healthcare, Salt Lake City, Utah
JAMA Surg. Published online March 11, 2020. doi:10.1001/jamasurg.2020.0090

In this issue of JAMA Surgery, Bailly et al1 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.

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