Bariatric surgery cuts pancreatic cancer risk for adults with or without type 2 diabetes
Click Here to Manage Email Alerts
Key takeaways:
- Adults with obesity who underwent bariatric surgery had lower risk for pancreatic cancer than those who did not have surgery.
- The reduced risk was more pronounced for adults with type 2 diabetes.
Adults with obesity who underwent bariatric surgery were less likely to develop pancreatic cancer than those who with obesity who did not have bariatric surgery, researchers reported.
In findings from a systematic review and meta-analysis published in Diabetes/Metabolism Research and Reviews, adults who had bariatric surgery had a 54% lower likelihood for pancreatic cancer than those who did not undergo the procedure, regardless of type 2 diabetes status. When researchers assessed only adults with type 2 diabetes, the risk for pancreatic cancer was 79% lower among those who had bariatric surgery compared with controls.
“While weight loss plays a significant role, other underlying mechanisms may also contribute, particularly in patients with obesity and type 2 diabetes, who may experience additional or more pronounced physiological changes following metabolic-bariatric surgery,” Angeliki M. Angelidi, MD, PhD, postdoctoral research fellow in the metabolism program at Board Institute of MIT and Harvard and Harvard Medical School, told Healio. “This suggests that metabolic-bariatric surgery may offer significant benefits beyond weight loss, particularly for high-risk populations such as those with obesity and type 2 diabetes.”
The primary outcome was incidence of pancreatic cancer for adults who had bariatric surgery vs. those who did not undergo surgery.
The meta-analysis included 11 cohort stories and one randomized controlled trial. The studies included a total of 3,711,243 adults, of whom 656,762 underwent bariatric surgery and 3,054,481 did not undergo surgery.
Four studies included adults with type 2 diabetes. The absolute incidence of pancreatic cancer among those participants was 0.04% for those who had bariatric surgery and 0.29% for controls. Adults with type 2 diabetes who underwent bariatric surgery had lower risk for pancreatic cancer compared with controls (RR = 0.21; 95% CI, 0.07-0.57).
Three studies assessed adults without type 2 diabetes. Pancreatic cancer incidence rates were 0.08% for adults who had bariatric surgery and 0.15% for those who did not have surgery. Adults who underwent bariatric surgery had reduced pancreatic cancer risk compared with controls (RR = 0.56; 95% CI, 0.41-0.78).
In an analysis of all adults, regardless of type 2 diabetes status, 363 adults who had bariatric surgery were diagnosed with pancreatic cancer compared with 7,204 adults in the control group. The bariatric surgery group had a lower risk for pancreatic cancer than controls (RR = 0.46; 95% CI, 0.3-0.71).
In subgroup analysis, adults who underwent sleeve gastrectomy had a lower risk for pancreatic cancer than those who did not have any surgery (RR = 0.24; 95% CI, 0.12-0.46). There was no significant difference in pancreatic cancer risk between those who had Roux-en-Y gastric bypass and controls, or between those who underwent sleeve gastrectomy vs. gastric bypass.
The researchers detected no evidence of publication bias.
“The mechanisms by which metabolic-bariatric surgery reduces the risk of pancreatic cancer have yet to be fully elucidated,” the researchers wrote. “The favorable impact of metabolic-bariatric surgery on the two important risk factors (obesity and type 2 diabetes) for pancreatic cancer could be a potential explanation for the beneficial effects.”
Angelidi said despite the findings, bariatric surgery should not be recommended solely for lowering pancreatic cancer risk and the decision to undergo bariatric surgery should be individualized for each person.
“Further comprehensive and well-designed research is needed to establish the long-term preventive impact of metabolic-bariatric surgery on pancreatic cancer risk, elucidate the underlying mechanisms and identify patient characteristics that would determine who would benefit most from each intervention,” Angelidi said.
For more information:
Angeliki M. Angelidi, MD, PhD, can be reached at angieang9@gmail.com.
Collapse
Click Here to Manage Email Alerts