Key result
Bariatric surgery linked to ~25% lower cancer risk vs. nonsurgical controls.
Why the study?
Obesity increases cancer risk, and postsurgical bariatric patients provide an ideal model to assess the association of substantial, sustained weight loss with cancer outcomes.
Does bariatric surgery reduce cancer incidence and mortality in obese patients compared to nonsurgical management?
Cohort (n=43,674)
Does bariatric surgery reduce cancer incidence and mortality in obese patients compared to nonsurgical management?
Hazard Ratio: 0.75 (95% CI 0.69–0.81)
p-value: p=< 0.001
Bariatric surgery is associated with a significantly lower risk of cancer incidence and mortality, particularly obesity-related cancers in females.
Bariatric surgery was associated with lower cancer incidence in severe obesity; leaves open causal effects and needs prospective confirmation before practice change.
OBJECTIVE: Obesity is associated with increased cancer risk. Because of the substantial and sustained weight loss following bariatric surgery, postsurgical patients are ideal to study the association of weight loss and cancer. METHODS: Retrospectively (1982-2019), 21,837 bariatric surgery patients (surgery, 1982-2018) were matched 1:1 by age, sex, and BMI with a nonsurgical comparison group. Procedures included gastric bypass, gastric banding, sleeve gastrectomy, and duodenal switch. Primary outcomes included cancer incidence and mortality, stratified by obesity- and non-obesity-related cancers, sex, cancer stage, and procedure. RESULTS: Bariatric surgery patients had a 25% lower risk of developing any cancers compared with a nonsurgical comparison group (hazard ratio [HR] 0.75; 95% CI 0.69-0.81; p < 0.001). Cancer incidence was lower among female (HR 0.67; 95% CI 0.62-0.74; p < 0.001) but not male surgery patients, with the HR lower for females than for males (p < 0.001). Female surgery patients had a 41% lower risk for obesity-related cancers (i.e., breast, ovarian, uterine, and colon) compared with nonsurgical females (HR 0.59; 95% CI 0.52-0.66; p < 0.001). Cancer mortality was significantly lower after surgery in females (HR 0.53; 95% CI 0.44-0.64; p < 0.001). CONCLUSIONS: Bariatric surgery was associated with lower all-cancer and obesity-related cancer incidence among female patients. Cancer mortality was significantly lower among females in the surgical group versus the nonsurgical group.
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Adams et al. (2023) conducted a cohort in Obesity (n=43,674). Bariatric surgery vs. Nonsurgical comparison group was evaluated on Cancer incidence (HR 0.75, 95% CI 0.69-0.81, p=< 0.001). Bariatric surgery was associated with a 25% lower risk of developing any cancers compared with a nonsurgical comparison group (HR 0.75; 95% CI 0.69-0.81; p < 0.001).
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