Breast Cancer Cell

Bariatric Surgery Cuts Cancer Risk from Obesity

Yet again we are reminded that bariatric surgery has quite an impressive record for improving the health of people with obesity. In a retrospective cohort study of 55,789 patients receiving bariatric surgery, risk of obesity-related cancer came down by half. Researchers matched the non-surgical control group using propensity scores for demographics, comorbidity, hormone therapy, and cancer screening.

The authors of this new study presented at DDW 2023 concluded:

“Bariatric surgery significantly decreases the risk of de novo cancers in patients with obesity. We noted a protective effect of BSx with a lower cumulative incidence of all obesity associated cancers at 10 year follow up in addition to lower prevalence rate of de novo breast, colon, liver, pancreatic, ovarian, and endometrial cancers. This study supports the importance of treating obesity with bariatric surgery to reduce societal and economic burden of cancer.”

Ten Years of Follow-up

After ten years of follow-up, 2,206 of the patients in the surgery group (4.0%) developed new cancers related to obesity. In the control group, the rate was more than twice as high – 8.9%. The rates for breast, colon, liver, pancreatic, ovarian, and endometrial cancers were all significantly lower in the surgery group.

Yale professor Loren Lane moderated a briefing on these findings with the lead investigator, Vibhu Chittajallu of University Hospitals in Cleveland. Lane, who was not involved in the study, noted the importance of these findings and their consistency with prior research:

“Obesity is clearly associated with a number of different cancers and that’s very important. So it makes logical sense that if you lose weight that you will reduce that risk.”

Reduced Incidence and Mortality

Earlier this year, a systematic review and meta-analysis had similar findings. Robert Wilson, Dhruvi Lathigara, and Devesh Kaushal found a 40 percent reduction in risk of obesity-related cancer incidence with bariatric surgery. Risk of cancer-related mortality was cut by about half.

More Potent Than Semaglutide

Add these data to the reasons that Yasmin Tayag recently pointed out in The Atlantic that “we’ve had a cheaper, more potent Ozempic alternative for decades.” That alternative is bariatric surgery.

People have indeed been reluctant to use it and we suspect that bias about obesity and its treatment plays a role. But we do not anticipate that bariatric surgery will go away anytime soon. Even as the number of people seeking treatment grows because of new obesity meds, we suspect more people will find their way to the effectiveness of bariatric surgery. Once people open their minds to the possibility of obesity care, more options come into view.

Click here for the abstract from DDW, here for the systematic review and meta-analysis. For further reporting on the research at DDW, click here and here. For the essay by Tayag, click here.

Breast Cancer Cell, scanning electron microscope image by the National Cancer Institute / Wikimedia Commons

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May 10, 2023