Investigators have demonstrated that bariatric surgery may be associated with a lower incidence of all-cancer and obesity-related cancer among female patients, according to a recent study published by Adams et al in Obesity. The new findings also suggested cancer mortality was significantly reduced following the procedure.
Background
Although previous studies have established a positive correlation between body mass index and cancer incidence, it is still unclear whether a voluntary reduction in body weight can reduce cancer risk. However, because patients may experience substantial and maintained weight loss following bariatric surgery, studies have reported reduced cancer incidence and mortality in these patient populations.
“This research represents another important study that strongly supports the long-term benefits of weight loss surgery in the prevention of cancer,” highlighted lead study author Ted D. Adams, PhD, MPH, of the Department of Internal Medicine as well as Nutrition and Integrative Physiology in the Division of Epidemiology at the University of Utah.
Study Methods and Results
In this retrospective study, the investigators used the Utah Population Database to compare the cancer incidence and mortality rates of 22,000 patients who had severe obesity and underwent bariatric surgery—including gastric bypass, gastric banding, sleeve gastrectomy, and duodenal switch procedures—with patients who did not undergo bariatric surgery between 1982 and 2019. The patients involved in the study were matched 1:1 on the basis of age, sex, and body mass index.
The investigators found that the patients who underwent bariatric surgery had a 25% lower risk of developing any type of cancer compared with those who did not undergo the procedure. Further, female patients who underwent the surgery had a 41% lower risk for developing obesity-related cancers—such as endometrial, ovarian, colorectal, and pre- and postmenopausal breast cancers—and a 47% lower risk of mortality compared with female patients who did not undergo the surgery. However, the investigators reported no statistically significant differences in the risk of cancer development between male patients who did or did not undergo bariatric surgery.
Conclusions
“Important findings of this study are that bariatric surgery results in lower incidence rates of [colorectal] cancer. Also, both pre- and postmenopausal [patients] experienced reduced breast cancer incidence following bariatric surgery, which may suggest weight loss among [female patients] in either category with severe obesity may benefit,” Dr. Adams emphasized.
“The results of this study add to the literature indicating that the large weight loss seen with bariatric surgery decreases the risk of several types of cancer. The risk of cancer in [female patients], who represent the majority of individuals who undergo bariatric surgery, was most greatly decreased. [Patients] with obesity and their health-care providers should strongly consider these benefits when discussing the pros and cons of bariatric surgery,” concluded David B. Sarwer, PhD, Associate Dean for Research and Director of the Center for Obesity Research and Education at the College of Public Health at Temple University, who was not involved in the study.
The investigators underscored that further bariatric surgery-driven mechanistic research may be needed to continue advancing cancer prevention.
Disclosure: The research in this study was partially funded by Ethicon Endo-Surgery, the Intermountain Medical Research and Education Foundation of Intermountain Health, and the Biomedical Research Program at Weill Cornell Medicine in Qatar. For full disclosures of the study authors, visit onlinelibrary.wiley.com.
