Risk of colorectal cancer after appendectomy: A systematic review and meta‐analysis
- 23 January 2023
- journal article
- review article
- Published by Wiley in Journal of Gastroenterology and Hepatology
- Vol. 38 (3), 350-358
- https://doi.org/10.1111/jgh.16108
Abstract
Background and AimAppendectomy is associated with various diseases, but whether it increases the risk of colorectal cancer (CRC) remains uncertain. We conducted a systematic review and meta-analysis aimed at investigating the suggested correlation between appendectomy and CRC. MethodsSystematic retrieval was performed using the PubMed, Embase, Cochrane library, Web of Science, and databases up to May 4, 2022, for studies reported the influence of appendectomy on CRC, colon cancer (CC) or rectal cancer (RC). Odd ratios (ORs) and 95% confidence intervals (CIs) of CRC after appendectomy were pooled using the random effects model. Subgroup analyses were carried on by region, sex, and tumor location. ResultsOur search identified 1743 articles, of which 22 studies from three continents published between 1964 and 2022 were eligible for inclusion. Overall, people with appendectomy had a higher risk of CRC (OR = 1.31; 95% CI [1.05, 1.62]). But the risk for Europeans was not significant (OR = 0.94; 95% CI [0.87, 1.02]; I-2 = 0%), while for Americans and Asians, appendectomy would increase the risk of CRC (OR = 1.68; 95% CI [1.15, 2.44]; I-2 = 65% and OR = 1.46; 95% CI [1.04, 2.05]; I-2 = 98%), especially in females and in developing countries. It is worth noting that appendectomy might be a protective factor for CC in European women (OR = 0.87; 95% CI [0.77, 0.98]; I-2 = 0%). ConclusionsAppendectomy may be a risk factor for CRC, with varying degrees in different populations. More high-quality cross-regional studies are needed for better clinical decision making.Keywords
This publication has 47 references indexed in Scilit:
- Generation of colonic IgA-secreting cells in the caecal patchNature Communications, 2014
- Childhood appendectomy, tonsillectomy, and risk for premature acute myocardial infarction--a nationwide population-based cohort studyEuropean Heart Journal, 2011
- Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analysesEuropean Journal of Epidemiology, 2010
- Does appendectomy increase the risk of colorectal adenocarcinoma?Open Medicine, 2009
- Meta-analysis of Observational Studies in EpidemiologyA Proposal for ReportingJAMA, 2000
- History of selected diseases and the risk of colorectal cancerEuropean Journal of Cancer and Clinical Oncology, 1991
- CHOLECYSTECTOMY AND CARCINOMA OF THE COLONThe Lancet, 1982
- Appendectomy and cancer risk: An epidemiological evaluationJournal of Chronic Diseases, 1968
- Incidence of appendectomies and tonsillectomies in cancer patientsCancer, 1966
- The appendix in relation to neoplastic diseaseCancer, 1964