A recent study based in France found that the use of bariatric surgery in patients with severe obesity was associated with a reduced incidence of esophageal and gastric cancer, compared with not undergoing bariatric surgery. Study findings were reported in the journal JAMA Surgery.
“The findings suggest that bariatric surgery can be performed as treatment for severe obesity without increasing the risk of esophageal and gastric cancer,” the researchers wrote in their report.
According to the researchers who performed the study, excess body weight is linked to esophageal and gastric cancers. However, they explained, bariatric procedures can lead to risks of acid and/or bile reflux, which may also potentially pose cancer risks. The researchers undertook this study to evaluate the incidence of esophageal and gastric cancer after bariatric surgery for obesity.
The researchers evaluated data from 2010 through 2017 from a national discharge database in France. Evaluated patients were adults who had severe obesity, and they were divided according to whether they had undergone bariatric surgery (surgical group) or had not (control group), with the patient groups propensity score-matched at a ratio of 1:2. The main outcome evaluated in the study was the incidence of esophageal and gastric cancer.
The data were from 303,709 patients who had undergone bariatric surgery and 605,140 patients who had not undergone such a procedure. Median ages were 40.2 years and 40.4 years, respectively. The control group had a mean follow-up time of 5.62 years, and the surgical group had a mean follow-up time of 6.06 years.
Overall, esophagogastric cancer was reported in 337 patients, with 83 of these being in the surgical group, compared with 254 in the control group. These corresponded to an incidence rate in the control group of 6.9 per 100,000 population per year, compared with 4.9 per 100,000 population per year in the surgical group (incidence rate ratio, 1.42; 95% CI, 1.11-1.82; P =.005). The hazard ratio (HR) of 0.76 (95% CI, 0.59-0.98; P =.03) for cancer incidence also favored the surgical group over the control group.
Survival also appeared more favorable for the surgical group. The surgical group had a 9-year overall survival rate of 99.1%, compared with 98.5% for the control group (HR, 0.60; 95% CI, 0.56-0.64; P <.001).
“In a cohort of almost 1 million patients with obesity, we observed a significant decrease in the incidence of esophageal and gastric cancer in the surgical group,” the researchers wrote in their report.
Disclosures: Some authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of disclosures.
Lazzati A, Poghosyan T, Touati M, Collet D, Gronnier C. Risk of esophageal and gastric cancer after bariatric surgery. JAMA Surg. Published online January 11, 2023. doi:10.1001/jamasurg.2022.6998