Does Appendectomy Increase Risk of Colorectal Cancer?

Does Appendectomy Increase Risk of Colorectal Cancer?

Douglas K. Rex, MD, MASGE, reviewing Liu Z, et al. J Gastroenterol Hepatol 2023 Jan 13.

This systematic review and meta-analysis identified 22 studies from 3 continents that addressed the risk of colorectal cancer (CRC) after appendectomy in the general population. The overall risk of CRC was higher after an appendectomy, with an odds ratio (OR) of 1.31, but the risk was not higher in European studies (OR, 0.94). However, an appendectomy increased the risk of CRC in American (OR, 1.68) and Asian patients (OR, 1.46).

Douglas K. Rex, MD, FASGE


If this is real, it’s unclear why there was no impact in Europe, causing the overall result to be suspect. It’s good to know, though, that an association between appendectomy and CRC has been made. The various possible health benefits of preserving the appendix warrant some consideration in an era when antibiotic treatment is possible in some cases of appendicitis.

Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.


Liu Z, Ma X, Zhu C, Fang JY. Risk of colorectal cancer after appendectomy: a systematic review and meta-analysis. J Gastroenterol Hepatol 2023 Jan 13. (Epub ahead of print) (

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