Appendectomy and Colorectal Cancer

NCT06091137 | Unknown

• 1 other identifier: 2022.203
• Study Type: observational
• Target: 180,000
• Locations: 1 country
• Sites: 1

Brief Summary

Colorectal cancer (CRC) is one of the most common cancer worldwide. Initiation and progression of CRC involve complex interactions among genetic, epigenetic and environmental factors. Given that hereditary and familial CRC only accounts for 2% to 5% of cases, environmental factors are the key triggers of CRC. Emerging evidence has indicated that gut microbes are an important environmental factor promoting CRC development. Gut dysbiosis has been shown to promote colorectal carcinogenesis in mice. Several individual bacterial species, such as the enterotoxigenic Bacteroides fragilis (ETBF), Fusobacterium nucleatum and Peptostreptococcus anaerobius, could exert carcinogenic effects by inducing direct DNA damage, oxidative damage and activating oncogenic signaling pathways. Recent studies have shown that the appendix plays an important role in maintaining homeostasis and biodiversity of gut microbiome by providing an ideal ecological niche for commensal bacteria and production of immunoglobulin A. Considering the key role of microorganisms in gastrointestinal pathophysiology, absence of appendix may result in disruption of microbiome homeostasis, which could potentially influence the risk of developing CRC. In terms of epidemiological evidence, the association of appendectomy with the risk of CRC development has been controversial, and to date no consensus has been attained. Although gut microorganisms could be a crucial pivot between appendectomy and risk of subsequent CRC development, the direct contribution of appendectomy and the underlying mechanisms are still largely unexplored. In this study, we aim to study

1. 1.the association between appendectomy and colorectal cancer, and
2. 2.the role of appendectomy in CRC risk through causing gut microbial dysbiosis.

Conditions

Colorectal Cancer; Appendicitis

Outcome Measures

Primary Outcomes (1)

• Appendectomy is associated with risk of subsequent CRC incidence

  Individuals underwent appendectomy from January 2000 to December 2020 will be retrieved from a population-based database (CDARS) in Hong Kong. For the control group, individuals without appendectomy between 2000 and 2020 based on the same exclusion criteria will be identified from the total population register of CDARS. For each case of appendectomy, we will select two matched referential individuals from the pool based on the year of birth and gender to study the association between appendectomy and CRC risk.

  3 years

Study Arms (2)

Non-appendectomy controls

Appendectomy cases

Eligibility Criteria

• Sex: all
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

60000 appendectomy cases and 120000 controls

You may qualify if:

• Individuals underwent appendectomy from January 2000 to December 2020

You may not qualify if:

• patients with the age ≤18 years at enrollment;
• Patients with any malignant diseases or inflammatory bowel disease history before enrollment;
• Patients with hereditary syndromes of colorectal adenomas or polyps (familial adenomatous polyposis, Lynch syndrome, etc.);
• Patients that underwent appendectomy for appendiceal neoplasms.

Sponsors & Collaborators

• Chinese University of Hong Kong: lead

Study Sites (1)

Institute of Digestive Disease, The Chinese University of Hong Kong

Shatin, 00000, Hong Kong

Location

MeSH Terms

Conditions

Colorectal Neoplasms; Appendicitis

Condition Hierarchy (Ancestors)

Intestinal Neoplasms; Gastrointestinal Neoplasms; Digestive System Neoplasms; Neoplasms by Site; Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Colonic Diseases; Intestinal Diseases; Rectal Diseases; Intraabdominal Infections; Infections; Gastroenteritis; Cecal Diseases

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: October 8, 2023
• First Posted: October 19, 2023
• Study Start: June 1, 2022
• Primary Completion: May 31, 2025
• Study Completion: May 31, 2025
• Last Updated: October 19, 2023

Record last verified: 2023-10

Locations

HK (1)