Bariatric surgery associated with over 50% reduction in cancer risk for individuals with obesity
Bariatric surgery could considerably decrease the risk of cancers related to obesity, such as those of the breast, colon, liver, pancreas, ovaries, and thyroid, in patients with obesity.
“Bariatric surgery, which includes sleeve gastrectomy, gastric bypass, and gastric band procedures, is the principal method for significant weight loss in individuals with obesity,” stated Dr. Vibhu Chittajallu, a gastroenterology fellow at Case Western Reserve University and University Hospitals Cleveland Medical Center, during a Digestive Disease Week media briefing. He highlighted that these procedures offer benefits beyond weight loss, such as enhancements in patients’ mental and physical well-being.
Chittajallu further added, “Emerging evidence suggests that the substantial weight reduction linked with bariatric surgery may also provide a protective shield against the development of cancers associated with obesity. My team and I decided to delve deeper into this trend.”
Chittajallu and his team used TriNetX, a database involving 47 U.S. healthcare institutions and over 107 million patients, to conduct a retrospective study from 2002 to 2022. They singled out adults with a Body Mass Index (BMI) over 35 who underwent bariatric surgery, comparing them with patients with obesity who didn’t have the surgery. The study accounted for risk factors like smoking history, alcohol use, heart disease, hormone therapies, and cancer-screening tests, including 55,789 individuals in each group.
The researchers also used the International Agency for Research on Cancer to identify cancers with “sufficient” evidence of a connection to obesity. This included esophageal adenocarcinoma, multiple myeloma, and cancers of the kidney, colon, rectum, stomach, liver, gallbladder, pancreas, ovary, endometrium, breast, and thyroid.
The results revealed that after ten years, the cumulative occurrence of obesity-related cancer was 4% (n = 2,206) in the bariatric surgery group and 8.9% (n = 4,960) in the nonsurgical control group (HR = 0.482; 95% CI, 0.459-0.507).
Chittajallu pointed out that the bariatric surgery group consistently exhibited lower numbers of new cases for all types of obesity-related cancers, including those of the breast, colon, liver, pancreas, ovaries, and thyroid.
“Although more research is required to fully understand the impact of bariatric surgery on cancer risk,” Chittajallu concluded, “our findings indicate that bariatric surgery is a promising area to investigate.”
Read MoreHigh obesity-related cancer mortality linked to easy access to fast food
Obesity has been a significant contributor to various health issues, including cancer. A recent cross-sectional study published in JAMA Oncology highlights the role of food environments in obesity-related cancer mortality. Communities with easy access to fast food were found to be 77% more likely to have high levels of obesity-related cancer mortality.
Researchers led by Dr. Malcolm Seth Bevel from the Medical College of Georgia analysed food access and cancer mortality data from over 3,000 counties in the United States. The study aimed to understand the association between food deserts (areas with limited access to grocery stores and healthy food options) and food swamps (areas with easy access to convenience stores and fast food) and obesity-related cancer mortality rates.
Using data from the U.S. Department of Agriculture Food Environment Atlas and the Centers for Disease Control and Prevention, the researchers calculated food desert and food swamp scores for each county. A higher score indicated fewer healthy food resources in the area.
The primary outcome of the study was obesity-related cancer mortality, defined as either high or low (71.8 or higher per 100,000 individuals and less than 71.8 per 100,000 individuals, respectively). The results showed that counties with high food swamp scores (easy access to fast food) were 77% more likely to have high rates of obesity-related cancer mortality.
Further analysis revealed a positive dose-response relationship between food desert scores, food swamp scores, and obesity-related cancer mortality rates. Counties with high rates of obesity-related cancer mortality also had a higher percentage of non-Hispanic Black residents, higher percentage of adults older than 65 years, higher rates of adult obesity, and higher rates of adult diabetes.
The study demonstrates the significant impact of food environments on obesity-related cancer mortality rates. Communities with easy access to fast food have a considerably higher risk of obesity-related cancer deaths. The findings emphasise the importance of promoting healthier food environments and improving access to nutritious food options in order to reduce obesity and its associated health risks, including cancer.
Read MoreBariatric surgery may reduce cancer risk in patients with obesity and type 2 diabetes
Research findings derived from a Swedish Obese Subjects (SOS) study, published in Diabetes Care, found that in people with obesity and type 2 diabetes (T2D), bariatric surgery may play a role in cancer prevention. “Durable” remission of T2D is often achieved after weight-loss surgery, further associating it with a reduced cancer risk.
The study examined long-term outcomes after bariatric surgery versus usual care in people with obesity. Researchers examined outcomes of 701 patients with obesity and T2D at baseline. A total of 393 of these patients (mean age, 48.6 years) underwent bariatric surgery while 308 patients (mean age, 50.5 years) received conventional obesity treatment. The investigators analysed cancer events, reported in the Swedish National Cancer Register, over the median follow-up of 21.3 years.
In patients treated with bariatric surgery, the incidence rate for first-time cancer during the follow-up period was 9.1 per 1,000 person-years (95% CI, 7.2–11.5). In contrast, the incidence rate for first-time cancer in patients treated with usual obesity care was 14.1 per 1,000 person-years (95% CI, 11.2–17.7). The incidence rate for first-time cancer diagnosis was significantly lower in the patients treated with bariatric surgery (adjusted hazard ratio [HR], 0.63; 95% CI, 0.44–0.89; P =.008).
Compared with the control group, bariatric surgery was associated with a significantly reduced incidence of cancer in women, (HR, 0.58; 95% CI, 0.38–0.90; P =.016). However, with bariatric surgery in men, there was no similar association (HR, 0.79; 95% CI, 0.46-1.38; P =.0413). Diabetes remission at 10 years follow-up was also associated with a reduction in cancer incidence (HR, 0.40; 95% CI, 0.22–0.74; P =.003).
The ascertainment of diabetes diagnoses was a limitation of the study, which were based on a single time point measurement and/or the use of a diabetes medication. Additionally, the majority of participants in the surgery group had received vertical banded gastroplasty or banding, which is rarely used today. High postoperative mortality following bariatric surgery was reported during the original SOS study.
“In conclusion, with increasing rates of obesity and diabetes worldwide, a greater emphasis on cancer prevention strategies is needed,” the researchers wrote. “Bariatric surgery may greatly reduce the risk of cancer among patients with obesity and diabetes. Durable diabetes remission seems imperative for cancer prevention in patients with obesity and diabetes.”
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