The role of colonoscopy in the workup of bariatric surgery patients

Mohammed B Al Haddad, MD, Nidal Dehni, MD, Abdelrahman A Nimeri, MD

SKMC/Cleveland Clinic Abu Dhabi. Bariatric

Cancer is the one of the most common causes of deaths in morbidly obese patients. (1) In addition, obese patients have an increased risk for developing colon cancer (2). Furthermore, obese individuals (BMI >30 kg/m2) have a 20% greater risk of developing colon cancer compared to normal weight individuals (BMI< 25kg/m2), and for every 5 kg weight gain the risk increases by 7% (3).

Obesity is a major health risk in the UAE; a screening program (Weqaya) showed that 67% of the Emirati population are either overweight or obese (4) In addition, colon cancer in the Emirati patient presents at a younger age and often with metastatic disease at the time of diagnosis (5). No guidelines are available to the appropriate timing for screening colonoscopy in morbidly obese patient considering bariatric surgery.

We retrospectively reviewed charts of all patients who had colonoscopy during the period from January 2009 to December 2011 at the BMI Abu Dhabi. Patients were divided into two groups based on BMI; Group A) patients with BMI >35 kg/m2 who had colonoscopy during their workup for bariatric surgery. Group B) patients with BMI <30 kg/m2.

Two hundred and twenty four screening colonoscopies were done at BMI Abu Dhabi during the study period. Group A consisted of 55 patients (females 38 (69%), age range 18-61 years, mean 44 years; and group B consisted of 174 patients (females 84 (47%), age range 14-87 years, mean 46 years . In the entire cohort, polyps were present in 7.1% of patients and cancer in 2.6% of patients. Group A patients had more polyps (20%) and cancer (5.4%) compared to group B patients (2.9%) and (1.7%) respectively.

Our study shows that morbidly obese people considering bariatric surgery are at an alarming risk of developing colonic polyps and cancers at a younger age. Clear guidelines for colon cancer screening are needed in this patient population.

Session: Poster Presentation

Program Number: P467

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