Annals of surgery · 2024
Appendectomy and Long-term Colorectal Cancer Incidence, Overall and by Tumor Fusobacterium nucleatum Status.
СтатьяПоддержка NIH: внешняя программаПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Kawamura Hidetaka, Ugai Tomotaka, Takashima Yasutoshi, Okadome Kazuo, Shimizu Takashi, Mima Kosuke, Akimoto Naohiko, Haruki Koichiro, Arima Kota, Zhao Melissa, Väyrynen Juha P, Wu Kana, Zhang Xuehong, Ng Kimmie, Nowak Jonathan A, Meyerhardt Jeffrey A, Giovannucci Edward L, Giannakis Marios, Chan Andrew T, Huttenhower Curtis, Garrett Wendy S, Song Mingyang, Ogino Shuji
Аннотация
OBJECTIVE: To test hypotheses that appendectomy history might lower long-term colorectal cancer risk and that the risk reduction might be strong for tumors enriched with Fusobacterium nucleatum , bacterial species implicated in colorectal carcinogenesis.
BACKGROUND: The absence of the appendix, an immune system organ and a possible reservoir of certain pathogenic microbes, may affect the intestinal microbiome, thereby altering long-term colorectal cancer risk.
METHODS: Utilizing databases of prospective cohort studies, namely the Nurses' Health Study and the Health Professionals Follow-up Study, we examined the association of appendectomy history with colorectal cancer incidence overall and subclassified by the amount of tumor tissue Fusobacterium nucleatum ( Fusobacterium animalis ). We used an inverse probability weighted multivariable-adjusted duplication-method Cox proportional hazards regression model.
RESULTS: During the follow-up of 139,406 participants (2,894,060 person-years), we documented 2811 incident colorectal cancer cases, of which 1065 cases provided tissue Fusobacterium nucleatum analysis data. The multivariable-adjusted hazard ratio of appendectomy for overall colorectal cancer incidence was 0.92 (95% CI, 0.84-1.01). Appendectomy was associated with lower Fusobacterium nucleatum -positive cancer incidence (multivariable-adjusted hazard ratio, 0.53; 95% CI, 0.33-0.85; P =0.0079), but not Fusobacterium nucleatum -negative cancer incidence (multivariable-adjusted hazard ratio, 0.98; 95% CI, 0.83-1.14), suggesting a differential association by Fusobacterium nucleatum status ( Pheterogeneity =0.015). This differential association appeared to persist in various participant/patient strata including tumor location and microsatellite instability status.
CONCLUSIONS: Appendectomy likely lowers the future long-term incidence of Fusobacterium nucleatum -positive (but not Fusobacterium nucleatum -negative) colorectal cancer. Our findings do not support the existing hypothesis that appendectomy may increase colorectal cancer risk.
BACKGROUND: The absence of the appendix, an immune system organ and a possible reservoir of certain pathogenic microbes, may affect the intestinal microbiome, thereby altering long-term colorectal cancer risk.
METHODS: Utilizing databases of prospective cohort studies, namely the Nurses' Health Study and the Health Professionals Follow-up Study, we examined the association of appendectomy history with colorectal cancer incidence overall and subclassified by the amount of tumor tissue Fusobacterium nucleatum ( Fusobacterium animalis ). We used an inverse probability weighted multivariable-adjusted duplication-method Cox proportional hazards regression model.
RESULTS: During the follow-up of 139,406 participants (2,894,060 person-years), we documented 2811 incident colorectal cancer cases, of which 1065 cases provided tissue Fusobacterium nucleatum analysis data. The multivariable-adjusted hazard ratio of appendectomy for overall colorectal cancer incidence was 0.92 (95% CI, 0.84-1.01). Appendectomy was associated with lower Fusobacterium nucleatum -positive cancer incidence (multivariable-adjusted hazard ratio, 0.53; 95% CI, 0.33-0.85; P =0.0079), but not Fusobacterium nucleatum -negative cancer incidence (multivariable-adjusted hazard ratio, 0.98; 95% CI, 0.83-1.14), suggesting a differential association by Fusobacterium nucleatum status ( Pheterogeneity =0.015). This differential association appeared to persist in various participant/patient strata including tumor location and microsatellite instability status.
CONCLUSIONS: Appendectomy likely lowers the future long-term incidence of Fusobacterium nucleatum -positive (but not Fusobacterium nucleatum -negative) colorectal cancer. Our findings do not support the existing hypothesis that appendectomy may increase colorectal cancer risk.