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Bariatric Surgery

Colorectal cancer after bariatric surgery (Cric-Abs 2020): Sicob (Italian society of obesity surgery) endorsed national survey

International Journal of Obesity volume 45, pages 2527–2531 (2021)Cite this article

Subjects

Abstract

Background

The published colorectal cancer (CRC) outcomes after bariatric surgery (BS) are conflicting, with some anecdotal studies reporting increased risks. The present nationwide survey CRIC-ABS 2020 (Colo-Rectal Cancer Incidence-After Bariatric Surgery-2020), endorsed by the Italian Society of Obesity Surgery (SICOB), aims to report its incidence in Italy after BS, comparing the two commonest laparoscopic procedures—Sleeve Gastrectomy (SG) and Roux-en-Y gastric bypass (GBP).

Methods

Two online questionnaires—first having 11 questions on SG/GBP frequency with a follow-up of 5–10 years, and the second containing 15 questions on CRC incidence and management, were administered to 53 referral bariatric, high volume centers. A standardized incidence ratio (SIR—a ratio of the observed number of cases to the expected number) with 95% confidence intervals (CI) was calculated along with CRC incidence risk computation for baseline characteristics.

Results

Data for 20,571 patients from 34 (63%) centers between 2010 and 2015 were collected, of which 14,431 had SG (70%) and 6140 GBP (30%). 22 patients (0.10%, mean age = 53 ± 12 years, 13 males), SG: 12 and GBP: 10, developed CRC after 4.3 ± 2.3 years. Overall incidence was higher among males for both groups (SG: 0.15% vs 0.05%; GBP: 0.35% vs 0.09%) and the GBP cohort having slightly older patients. The right colon was most affected (n = 13) and SIR categorized/sex had fewer values < 1, except for GBP males (SIR = 1.07).

Conclusion

Low CRC incidence after BS at 10 years (0.10%), and no difference between procedures was seen, suggesting that BS does not trigger the neoplasm development.

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Fig. 1: CRC incidence (number of cases) from 1 to 10 years after bariatric procedure.

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Author information

Author notes

  1. These authors contributed equally: Maria Chiara Ciccioriccio, Angelo Iossa.

Authors and Affiliations

  1. Department of Medical-Surgical Sciences and Biotechnologies, Division of General Surgery and Bariatric Centre of Excellence IFSO-EC, University of Rome “La Sapienza”, Rome, Italy

    Maria Chiara Ciccioriccio, Angelo Iossa, Cristian Eugeniu Boru, Francesco De Angelis, Pietro Termine, Mary Giuffrè & Gianfranco Silecchia

  2. Public Health Department “Federico II” University of Naples, Naples, Italy

    Luigi Angrisani

  3. Surgical Department, Hospital of Gorizia, Gorizia, Italy

    Alessandro Balani

  4. Bariatric/Metabolic Unit A.S.S. del Garda, Desenzano del Garda, Italy

    Fabrizio Bellini

  5. Bariatric/Metabolic Unit Gruppo San Donato-Bergamo, Bergamo, Italy

    Vincenzo Borrelli

  6. Surgical Department, San Giovanni Battista Hospital, Foligno, Perugia, Italy

    Marcello Boni

  7. Division of General Surgery, San Giovanni Decollato-Andosilla Hospital, Civita Castellana, ASL VT, Italy

    Fabio Cesare Campanile

  8. General and Oncologic Surgery Department, Centre of Advanced Laparoscopic Surgery, Centre of Bariatric Surgery, San Marco Hospital GSD, Zingonia, Italy

    Giovanni Cesana & Stefano Olmi

  9. Baritaric Unit- Villa Serena Città S. Angelo (Pe), Città Sant’Angelo, Italy

    Franco Ciampaglia

  10. Department of General, Oncological and Metabolic Surgery, Castelfranco and Montebelluna Hospitals, Treviso, Italy

    Maurizio De Luca & Natale Pellicanò

  11. Bariatric Unit E.O. Ospedali Galliera, Genova, Italy

    Marco Antonio De Paoli

  12. Department of Surgery, Padova University Hospital, Padua, Italy

    Mirto Foletto

  13. Department of Biomedical and Clinical Sciences “Luigi Sacco”, L. Sacco Hospital, University of the Studies of Milan, Milan, Italy

    Diego Foschi

  14. Obesity Unit, Department of Surgery, University of Rome “Tor Vergata”, Rome, Italy

    Paolo Gentileschi

  15. Emergency and Metabolic Surgery Department, Pineta Grande Hospital, Caserta, Italy

    Cristiano Giardiello

  16. Department of Pathophysiology and Transplantation, INCO and Department of General Surgery, Istituto Clinico Sant’ Ambrogio, University of Milan, Milan, Italy

    Alessandro Giovanelli

  17. Department of Surgery, Dolo Hospital, Via Pasteur, Dolo, VE, Italy

    Mario Godina

  18. Department of General Surgery, Istituto Clinico Humanitas San Pio X, Humanitas University, Milan, Milan, Italy

    Ezio Lattuada

  19. Department of Surgery, Chief of Bariatric and Metabolic Surgery Unit, Santa Maria Nuova Hospital, Piazza Santa Maria Nuova, Florence, Italy

    Marcello Lucchese

  20. General and Endocrine Surgery, AORN “A. Cardarelli”, Naples, Italy

    Emilio Manno

  21. Humanitas Research Hospital, IRCCS, Rozzano, MI, Italy

    Giuseppe Maria Marinari

  22. Department of General Surgery, “M. Rubino” University Hospital Polyclinic of Bari, Bari, Italy

    Gennaro Martines

  23. Department of Surgery, Santa Maria degli Angeli Hospital, Santa Maria, Pordenone, Italy

    Bernardo Marzano

  24. General Surgery Unit, Aosta Regional Hospital, Aosta, Italy

    Paolo Millo

  25. Obesity Surgery Unit, Surgical Department, “AO Brotzu” Hospital, Cagliari, Italy

    Roberto Moroni

  26. Advanced Biomedical Sciences Department, “Federico II” University, Naples, Italy

    Mario Musella

  27. Department of General Surgery, University Hospital of Messina “G. Martino”, Messina, Italy

    Giuseppe Navarra

  28. Unit of General Surgery 2, IRCCS Policlinico San Matteo Foundation, Pavia, Italy

    Andrea Peri

  29. Department of General and Digestive Surgery, Villa d’Agri Hospital, Villa d’Agri of Marsicovetere, Potenza, Italy

    Nicola Perrotta

  30. Center of Excellence of Bariatric Surgery of the Italian Society of Obesity Surgery and Metabolic Disease (SICOB), Unit of General and Emergency Surgery, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Mercato San Severino, Salerno, Italy

    Vincenzo Pilone

  31. Department of General Surgery and Medical-Surgical Specialties, University of Catania, Catania, Italy

    Luigi Piazza

  32. U.O.C. Chirurgia Endocrina e Metabolica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy

    Marco Raffaelli

  33. Magenta Hospital, Milan, Italy

    Giuliano Sarro

  34. S.Lorenzino clinic of cesena-Italy, Director of Bariatric Unit, San Raffaele Vita Salute University, Milan, Italy

    Angelo Michele Schettino

  35. Metabolic, Bariatric and Transplant Surgery Unit, San Raffaele Scientific Institute, San Raffaele Vita Salute University, Milan, Italy

    Socci Carlo

  36. Department of Surgical Sciences, Unit of BariatricSurgery, S. Maria Alle Scotte Hospital, University of Siena, Siena, SI, Italy

    Giuseppe Vuolo

  37. Department of General Surgery, Fatebenfratelli Hospital, Milano, MI, Italy

    Marco Antonio Zappa

Authors
  1. Maria Chiara Ciccioriccio
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  2. Angelo Iossa
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  3. Cristian Eugeniu Boru
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  4. Francesco De Angelis
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  5. Pietro Termine
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  6. Mary Giuffrè
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  7. Gianfranco Silecchia
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Consortia

CRIC-ABS 2020 GROUP

  • Luigi Angrisani
  • , Alessandro Balani
  • , Fabrizio Bellini
  • , Vincenzo Borrelli
  • , Marcello Boni
  • , Fabio Cesare Campanile
  • , Giovanni Cesana
  • , Franco Ciampaglia
  • , Maurizio De Luca
  • , Marco Antonio De Paoli
  • , Mirto Foletto
  • , Diego Foschi
  • , Paolo Gentileschi
  • , Cristiano Giardiello
  • , Alessandro Giovanelli
  • , Mario Godina
  • , Ezio Lattuada
  • , Marcello Lucchese
  • , Emilio Manno
  • , Giuseppe Maria Marinari
  • , Gennaro Martines
  • , Bernardo Marzano
  • , Paolo Millo
  • , Roberto Moroni
  • , Mario Musella
  • , Giuseppe Navarra
  • , Stefano Olmi
  • , Natale Pellicanò
  • , Andrea Peri
  • , Nicola Perrotta
  • , Vincenzo Pilone
  • , Luigi Piazza
  • , Marco Raffaelli
  • , Giuliano Sarro
  • , Angelo Michele Schettino
  • , Socci Carlo
  • , Giuseppe Vuolo
  •  & Marco Antonio Zappa

Contributions

MCC and AI Designed and wrote the study protocol. Create the survey form and elaborate the data. CEB and FDA Reviewed the manuscript andhelps to analyze the results. PT and MG Elaborate tha data and merged the database. GS Supervised the outcomes and the data analysis. Coordinate the centers involved. CRIC-ABS group Partecipate actively to the survey and provide access to their database.

Corresponding author

Correspondence to Angelo Iossa.

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The authors declare no competing interests.

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Ciccioriccio, M.C., Iossa, A., Boru, C.E. et al. Colorectal cancer after bariatric surgery (Cric-Abs 2020): Sicob (Italian society of obesity surgery) endorsed national survey. Int J Obes 45, 2527–2531 (2021). https://doi.org/10.1038/s41366-021-00910-6

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