Obesity surgery, such as gastric banding, gastric bypass, and sleeve gastrectomy, may modify the risk of cancer for obese persons, according to a study published in the British Journal of Surgery.
Bariatric surgery is the only evidence-based treatment for weight reduction among obese persons, resulting in improvements for diabetes, cardiovascular conditions, and long-term survival. Obesity surgery’s effects on cancer risk, however, requires further study.
For this study, researchers accessed the Hospital Episode Statistics database in England to analyze health outcomes of 17,588 patients with obesity; 8794 patients who underwent bariatric surgery were matched with nonsurgery patients. Investigators sought to determine the impact of bariatric surgery on the risk of breast, endometrial, prostate, colorectal, and esophageal cancers. The median follow-up was 55 months, and 56.6%, 33.6%, and 9.8% underwent gastric bypass, gastric banding, and sleeve gastrectomy, respectively.
Results showed that patients who underwent bariatric surgery had risk reductions of hormone-related cancers (breast, endometrial, prostate) compared with the nonsurgery group. Specifically, patients in the surgery group had a 75% odds reduction for breast cancer, 79% for endometrial cancer, and a 63% reduction for prostate cancer compared with patients who did not undergo bariatric surgery.
Gastric bypass resulted in the largest risk reduction for hormone-related cancers, but gastric banding and sleeve gastrectomy also led to strongly reduced risk of cancers.
Bariatric surgery however, led to a near 2-fold increase in the risk of colorectal cancer compared with nonsurgery patients; gastric bypass was the only procedure associated with increased risk.
Mackenzie H, Markar SR, Askari A, et al. Obesity surgery and risk of cancer[published online July 13, 2018]. Br J Surg.doi: 10.1002/bjs.10914