Evidence map›Paper›PMID 38708875›Full record

ArticleAnnals of surgery2025

Appendectomy and Long-term Colorectal Cancer Incidence, Overall and by Tumor Fusobacterium nucleatum Status.

Hidetaka Kawamura, Tomotaka Ugai, Yasutoshi Takashima, Kazuo Okadome, Takashi Shimizu, Kosuke Mima, Naohiko Akimoto, Koichiro Haruki, Kota Arima, Melissa Zhao and 13 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Beyond the biopsy: the new era of non-invasive staging and biomarkers in colorectal cancer.Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico · 2026
    Review
  2. Review
  3. Review
  4. Highly Sensitive DNA Testing of Fusobacterium nucleatum in Colorectal Tumors.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025
    Article
  5. Microorganisms · 2025
    Article
  6. Article
  7. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Hidetaka KawamuraProgram in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA.
Tomotaka UgaiProgram in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA.
Yasutoshi TakashimaProgram in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA.
Kazuo OkadomeProgram in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA.
Takashi ShimizuProgram in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA.
Kosuke MimaProgram in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA.
Naohiko AkimotoProgram in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA.
Koichiro HarukiProgram in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA.
Kota ArimaProgram in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA.
Melissa ZhaoProgram in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA.
Juha P VäyrynenProgram in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA.
Kana WuDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
Xuehong ZhangDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
Kimmie NgDepartment of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA.
Jonathan A NowakProgram in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA.
Jeffrey A MeyerhardtBroad Institute of MIT and Harvard, Cambridge, MA.
Edward L GiovannucciDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA.
Marios GiannakisDepartment of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA.
Andrew T ChanDepartment of Medicine, Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Curtis HuttenhowerDepartment of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA.
Wendy S GarrettBroad Institute of MIT and Harvard, Cambridge, MA.
Mingyang SongDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA.
Shuji OginoProgram in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA.

Funding

Statistical MethodsP01CA087969 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI TWOROGER, SHELLEY S · 2000 to 2019
$77.8M
Validity of Diet and Activity Measures in WomenP01CA055075 · NCI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI GIOVANNUCCI, EDWARD · 1991 to 2009
$41.8M
Long Term Multidisciplinary Study of Cancer in Women: The Nurses Health StudyUM1CA186107 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI ELIASSEN, A. HEATHER, STAMPFER, MEIR · 2014 to 2023
$22.3M
Cancer Epidemiology Cohort in Male Health ProfessionalsU01CA167552 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Lorelei Mucci, Walter C. Willett · 2017 to 2026
$17.0M
Cancer Epidemiology Cohort in Male Health ProfessionalsUM1CA167552 · NCI · HARVARD SCHOOL OF PUBLIC HEALTH · PI WILLETT, WALTER C. · 2012 to 2016
$11.5M
Inflammation and Colorectal NeoplasiaR01CA137178 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI CHAN, ANDREW T · 2009 to 2019
$6.5M
Accelerating Transdisciplinary Epidemiology of Colorectal CancerR35CA197735 · NCI · DANA-FARBER CANCER INST · PI OGINO, SHUJI · 2015 to 2021
$6.0M
Novel randomized controlled trials of vitamin D supplementation in patients with colorectal cancer: Impact on survival and biologyR01CA205406 · NCI · DANA-FARBER CANCER INST · PI Kimmie Ng · 2017 to 2026
$4.9M
The Gut Microbiome, Lifestyle, and Colorectal NeoplasiaU01CA261961 · NCI · HARVARD UNIVERSITY D/B/A HARVARD SCHOOL OF PUBLIC HEALTH · PI Mingyang Song · 2022 to 2026
$3.0M
Mentored Patient-Oriented Research in Digestive DiseasesK24DK098311 · NIDDK · MASSACHUSETTS GENERAL HOSPITAL · PI CHAN, ANDREW T · 2013 to 2017
$930k
Integration of Immunology and Microbiology into Molecular Pathological Epidemiology of Colorectal CancerR50CA274122 · NCI · BRIGHAM AND WOMEN'S HOSPITAL · PI UGAI, TOMOTAKA · 2023 to 2025
$506k
Cancer Research UK 27140NCI NIH HHS P01 CA055075NCI NIH HHS P01 CA087969NCI NIH HHS R01 CA137178NCI NIH HHS R01 CA205406NCI NIH HHS R35 CA197735NCI NIH HHS R50 CA274122NCI NIH HHS U01 CA167552NCI NIH HHS U01 CA261961NCI NIH HHS UM1 CA167552NCI NIH HHS UM1 CA186107NIDDK NIH HHS K24 DK098311
6 · The paper itself

Abstract

objectiveTo 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.

backgroundThe 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.

methodsUtilizing 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.

resultsDuring 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.

conclusionsAppendectomy 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.

Indexed as

AppendectomyColorectal NeoplasmsFusobacterium InfectionsFusobacterium nucleatumAdultAgedFemaleFollow-Up StudiesHumansIncidenceMaleMiddle AgedProspective StudiesRisk FactorsUnited Statescolorectal neoplasmsmicrobiotamolecular pathological epidemiologypreventionrisk factor

Identifiers

PMID38708875
PMCPMC11538369

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