Does Biliopancreatic Diversion Carry Increased Risk for Colorectal Cancer? A Cohort Study

Overview

Journal Obes Surg

Date 2008 Jan 4

PMID 18172741

Citations 3

Authors

Gian Franco Adami

Francesco S Papadia

Giuseppe M Marinari

Giovanni B Camerini

Nicola Scopinaro

Affiliations

Soon will be listed here.

Abstract

Background: Because of the rearrangement of the gastrointestinal tract, biliopancreatic diversion (BPD) could lead to an increased risk of colorectal cancer caused by possible carcinogenetic action of the unabsorbed food and bile acid on colonic mucosa.

Methods: The incidence of colorectal cancer in 1,898 obese subjects submitted to BPD from May 76 to July 2002 with a minimum follow-up of 5 years was retrospectively evaluated.

Results: Among 28,811 person-years, seven cases of colorectal cancer were detected, for an overall incidence of 29.4 per 100,000, which is not different from that observed in the general Italian population, and lower than that reported for obese and type 2 diabetes patients. Logistic regression model suggests that occurrence of colorectal cancer is positively related to the time elapsed from BPD.

Conclusion: This study indicates that BPD does not carry any increased risk for colorectal cancer. The complete postoperative restoration of insulin sensibility could exert a valuable protective action.

Citing Articles

Gastro-Intestinal Tract Cancers Following Bariatric Surgery: a Narrative Review.

Ebrahimi R, Kermansaravi M, Khalaj A, Eghbali F, Mousavi A, Pazouki A Obes Surg. 2019; 29(8):2678-2694.

PMID: 31175561 DOI: 10.1007/s11695-019-04007-y.

The role of bile acids in reducing the metabolic complications of obesity after bariatric surgery: a systematic review.

Penney N, Kinross J, Newton R, Purkayastha S Int J Obes (Lond). 2015; 39(11):1565-74.

PMID: 26081915 DOI: 10.1038/ijo.2015.115.

Right colon carcinoma infiltrating the alimentary limb in a patient with biliopancreatic diversion.

Lopez-Tomassetti Fernandez E, Hernandez Hernandez J, Jorge V Int Surg. 2014; 99(4):354-8.

PMID: 25058764 PMC: 4114360. DOI: 10.9738/INTSURG-D-12-00017.1.

References

Potter J . Nutrition and colorectal cancer. Cancer Causes Control. 1996; 7(1):127-46. DOI: 10.1007/BF00115644. View

Adami G, Cordera R, Camerini G, Marinari G, Scopinaro N . Long-term normalization of insulin sensitivity following biliopancreatic diversion for obesity. Int J Obes Relat Metab Disord. 2004; 28(5):671-3. DOI: 10.1038/sj.ijo.0802618. View

Verdecchia A, Micheli A, Colonna M, Moreno V, Izarzugaza M, Paci E . A comparative analysis of cancer prevalence in cancer registry areas of France, Italy and Spain. Ann Oncol. 2002; 13(7):1128-39. DOI: 10.1093/annonc/mdf160. View

Giovannucci E, Michaud D . The role of obesity and related metabolic disturbances in cancers of the colon, prostate, and pancreas. Gastroenterology. 2007; 132(6):2208-25. DOI: 10.1053/j.gastro.2007.03.050. View

Scopinaro N, Adami G, Marinari G, Gianetta E, Traverso E, Friedman D . Biliopancreatic diversion. World J Surg. 1998; 22(9):936-46. DOI: 10.1007/s002689900497. View

Harris P, Ferguson L . Dietary fibres may protect or enhance carcinogenesis. Mutat Res. 1999; 443(1-2):95-110. DOI: 10.1016/s1383-5742(99)00013-7. View

MacInnis R, English D, Hopper J, Haydon A, Gertig D, Giles G . Body size and composition and colon cancer risk in men. Cancer Epidemiol Biomarkers Prev. 2004; 13(4):553-9. View

Harris D, Go V . Vitamin D and colon carcinogenesis. J Nutr. 2004; 134(12 Suppl):3463S-3471S. DOI: 10.1093/jn/134.12.3463S. View

Yang Y, Hennessy S, Lewis J . Type 2 diabetes mellitus and the risk of colorectal cancer. Clin Gastroenterol Hepatol. 2005; 3(6):587-94. DOI: 10.1016/s1542-3565(05)00152-7. View

10.

Bray F, Sankila R, Ferlay J, Parkin D . Estimates of cancer incidence and mortality in Europe in 1995. Eur J Cancer. 2001; 38(1):99-166. DOI: 10.1016/s0959-8049(01)00350-1. View

11.

Giovannucci E . Insulin, insulin-like growth factors and colon cancer: a review of the evidence. J Nutr. 2001; 131(11 Suppl):3109S-20S. DOI: 10.1093/jn/131.11.3109S. View

12.

Martinez M, Giovannucci E . Diet and the prevention of cancer. Cancer Metastasis Rev. 1998; 16(3-4):357-76. DOI: 10.1023/a:1005860413247. View

13.

Debruyne P, Bruyneel E, Li X, Zimber A, Gespach C, Mareel M . The role of bile acids in carcinogenesis. Mutat Res. 2001; 480-481:359-69. DOI: 10.1016/s0027-5107(01)00195-6. View

14.

Larsson S, Wolk A . Obesity and colon and rectal cancer risk: a meta-analysis of prospective studies. Am J Clin Nutr. 2007; 86(3):556-65. DOI: 10.1093/ajcn/86.3.556. View

15.

Moore L, Bradlee M, Singer M, Splansky G, Proctor M, Ellison R . BMI and waist circumference as predictors of lifetime colon cancer risk in Framingham Study adults. Int J Obes Relat Metab Disord. 2004; 28(4):559-67. DOI: 10.1038/sj.ijo.0802606. View

16.

Will J, Galuska D, Vinicor F, Calle E . Colorectal cancer: another complication of diabetes mellitus?. Am J Epidemiol. 1998; 147(9):816-25. DOI: 10.1093/oxfordjournals.aje.a009534. View

17.

Giovannucci E . Insulin and colon cancer. Cancer Causes Control. 1995; 6(2):164-79. DOI: 10.1007/BF00052777. View

18.

Hu F, Manson J, Liu S, Hunter D, Colditz G, Michels K . Prospective study of adult onset diabetes mellitus (type 2) and risk of colorectal cancer in women. J Natl Cancer Inst. 1999; 91(6):542-7. DOI: 10.1093/jnci/91.6.542. View

19.

Chaplin M . Bile acids, fibre and colon cancer: the story unfolds. J R Soc Health. 1998; 118(1):53-61. DOI: 10.1177/146642409811800111. View

20.

Adami G, Papadia F, Scopinaro N . Colorectal cancer after biliopancreatic diversion for obesity. Int J Obes (Lond). 2007; 31(12):1864. DOI: 10.1038/sj.ijo.0803669. View