American College of Gastroenterology Annual Meeting

American College of Gastroenterology Annual Meeting

Source:

Shwani Z, et al. Presentation: Effect of weight loss surgery and weight loss medications on the risk of colorectal cancer: A nationwide population-based cohort study. Presented at: ACG Annual Scientific Meeting; Oct. 22-27, 2021; Las Vegas (hybrid meeting).

Disclosures: Shwani reports no relevant financial disclosures.
November 11, 2021
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Obesity links to CRC among weight loss surgery, medication

Source:

Shwani Z, et al. Presentation: Effect of weight loss surgery and weight loss medications on the risk of colorectal cancer: A nationwide population-based cohort study. Presented at: ACG Annual Scientific Meeting; Oct. 22-27, 2021; Las Vegas (hybrid meeting).

Disclosures: Shwani reports no relevant financial disclosures.
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LAS VEGAS – Obesity was an independent risk factor for the development of colorectal cancer among patients who underwent weight loss surgery or who were on weight loss medication, according to a presentation.

“Obesity prevalence is on the rise throughout the world and globally and has doubled over the last four decades,” Zryan Shwani, MD, of Johns Hopkins Sibley Memorial Hospital in Washington, D.C., said. “Our primary aim was to evaluate the risk of CRC after weight loss surgery (WLS) and weight loss medications (WLM).”

From the IBM Explorys clinical database, researchers analyzed 43,050 patients aged 18 to 75 years who underwent either Roux-en-Y gastrojejunostomy (RYGB; 22%) or sleeve gastrectomy (SG; 78%) and developed subsequent CRC as well as 117,730 patients dosed with orlistat (9%), phentermine (18%), lorcaserin (18%), naltrexone (24%) or liraglutide (31%) who did not undergo surgery. They calculated the risk for CRC compared with a control cohort and evaluated the degree of BMI reduction following surgery or medication.

Among patients who underwent surgery, 2.89% of patients developed CRC which included 0.53% of patients in the RYGB group and 0.15% of patients in the SG group. While surgery correlated with a lower risk for CRC compared with control (OR = 0.62; 95% CI, 0.58-0.66), the risk for CRC was not reduced among patients who underwent RYGB (OR = 1.09; 95% CI, 0.82-1.43). Similarly, though 3.47% of patients dosed with weight loss medication developed CRC, it correlated with a lower risk for CRC overall (OR = 0.75; 95% CI, 0.72-0.78) with no significant difference in risk among patients who took orlistat (OR = 0.94; 95% CI, 0.71-1.25) despite previous data that linked orlistat to the development of aberrant crypt foci as a precursor to CRC and adenoma. Overall, the risk for CRC was approximately 2.5 times higher among obese patients (OR = 2.48; 95% CI, 2.45-2.51).

“Ultimately our data identifies further evidence that obesity is an independent but modifiable risk factor for colon cancer [and] that both weight loss surgery and weight loss medications offer similar risk reduction,” Shwani concluded. “Across all points of contact we have an opportunity to decrease our patients’ risk for CRC by addressing obesity in our clinics.”