Bariatric surgery may reduce cancer risk in obesity by more than half
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Bariatric surgery may significantly lower the risk for obesity-related cancers, including breast, colon, liver, pancreatic, ovarian and thyroid, in patients with obesity.
“The primary modality for significant weight loss in obesity is bariatric surgery, including sleeve gastrectomy, gastric bypass and gastric band procedures,” Vibhu Chittajallu, MD, a gastroenterology fellow at Case Western Reserve University and University Hospitals Cleveland Medical Center, said during the Digestive Disease Week media briefing. “Benefits to these procedures other than weight loss include improvement in patients’ mental and physical well-being.”
He added, “There is growing evidence that the significant weight loss associated with bariatric surgery may have a protective effect against the formation of obesity-associated cancer as well. My team and I set out to investigate this trend further.”
Using TriNetX, a multi-institutional database of 47 U.S. health care organizations and more than 107 million patients, Chittajallu and colleagues conducted a retrospective study from 2002 to 2022. They identified adults with a BMI over 35 who underwent bariatric surgery and compared them with patients who were obese but did not undergo surgery, including 55,789 individuals in each group after controlling for risk factors such as smoking history, alcohol use, heart disease, hormone therapies and cancer-screening tests.
Researchers also used the International Agency for Research on Cancer to determine cancers with “sufficient” evidence linked to obesity, which included esophageal adenocarcinoma, multiple myeloma and cancers of the kidney, colon, rectum, stomach, liver, gallbladder, pancreas, ovary, endometrium, breast and thyroid.
According to results, the cumulative incidence of obesity-related cancer at 10 years 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 also noted the bariatric surgery group had “consistently lower” numbers of new cases for all types of obesity-related cancer, including breast (501 vs. 751), colon (201 vs. 360), liver (969 vs. 2,198), pancreatic (54 vs. 86), ovarian (130 vs. 214) and thyroid (154 vs. 175).
“More research needs to be done to better understand how bariatric surgery affects cancer risk,” Chittajallu said, “but our findings suggest bariatric surgery is an exciting avenue to explore.”
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Chittajallu V, et al. Abstract 443: Bariatric surgery (BSx) decreases the risk of developing cancer: A multicenter population-based study. Presented at: Digestive Disease Week; May 5-9, 2023; Chicago (hybrid meeting).
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