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Bariatric surgery can significantly reduce obesity-related cancer risk

3 May 2021

Wow - what a breakthrough finding!  This is a fact that is being more completely uncovered as these types of studies start publishing their results.  It was known that the incidence of certain 'obesity-related cancers' were decreased in individuals undergoing bariatric surgery but the reasons why on a cellular level were unknown.  This study concurs with what was already known but has identified a reduction in all cancers incidence in those who underwent Bariatric Surgery.  There must be a reason for this relationship but the actual causative factor will be difficult to pinpoint.  More laboratory research is likely to help with putting more pieces of the puzzle together.  Here we have another benefit related to the effects of weight loss surgery!  If you are keen to discuss this, or other things regarding weight loss surgery, please don't hesitate to make contact.

Have a good day. 

Steph

Bariatric surgery can significantly reduce the risk of cancer - especially obesity-related cancers - by as much as half in certain individuals, according to a study by researchers at Rutgers Robert Wood Johnson Medical School's Center for Liver Diseases and Liver Masses.

The research, ‘Bariatric Surgery Reduces Cancer Risk in Adults with Nonalcoholic Fatty Liver Disease and Severe Obesity’, published in the journal Gastroenterology, is the first to show bariatric surgery significantly decreases the risk of cancer in individuals with severe obesity and nonalcoholic fatty liver disease (NAFLD). The risk reduction is even more pronounced in individuals with NAFLD-cirrhosis, the researchers said. 

"We knew that obesity leads to certain problems, including cancer, but no one had ever looked at it the other way around, whether weight loss actually reduced the risk of those cancers," explained study author, Dr Vinod K Rustgi, professor of medicine, clinical director of hepatology and Director of the Center for Liver Diseases and Liver Masses, Robert Wood Johnson Medical School. "Our study showed that all cancers were decreased, but obesity-related cancers in particular were decreased even more. Specifically, it showed a reduction in risk for all types of cancer by 18 percent, with the risk for obesity-related cancers being reduced by 25 percent. When comparing cirrhotic versus non-cirrhotic patients, cancer risk was reduced by 38 percent and 52 percent, respectively."

The retrospective study looked at de-identified claims data of more than 98,000 privately insured individuals age 18 to 64 years old who were diagnosed with severe obesity and NAFLD between 2007 and 2017. Of those, 33,435 (34.1%) received bariatric surgery. In those without surgery,1,898 incident cases of cancer occurred over 115,890.11 person-years of follow-up, compared with 925 cancer cases over 67,389.82 person-years among surgery patients (crude rate ratio 0.84; 95% CI: 0.77 to 0.91).

The inverse-probability-of-treatment-weighted-adjusted risk of any cancer and obesity related cancer was reduced by 18% and 25%, respectively, in patients with versus without bariatric surgery. The adjusted risks of any cancer and obesity-related cancer were significantly lower in cirrhotic versus non-cirrhotic patients who underwent surgery. In cancer[1]specific models, bariatric surgery was associated with significant risk reductions for colorectal, pancreatic, endometrial, thyroid cancers, hepatocellular carcinoma, and multiple myeloma.

In addition to an overall reduction in cancer risk for these individuals, researchers found that bariatric surgery was associated with significant risk reductions in these individuals for the following obesity-related cancers: colorectal, pancreatic, endometrial and thyroid cancers, as well as hepatocellular carcinoma and multiple myeloma.

"Understanding the connection between NAFLD and cancer may identify new targets and treatments, such as antidiabetic-, satiety-, or GLP-1-based medications, for chemoprevention in NAFLD/NASH. Though bariatric surgery is a more aggressive approach than lifestyle modifications, surgery may provide additional benefits, such as improved quality of life and decreased long-term healthcare costs," the researchers indicate.

The next step for Center researchers is to explore whether this reduced cancer risk holds true for individuals with severe obesity who do not have NAFLD. They are also planning to study the mechanism by which this reduced risk occurs and whether factors such as hormonal changes induced by weight loss are the cause of reduced cancer risk, rather than just the weight loss itself,. In addition, Center researchers currently are studying the impact of bariatric surgery on cardiovascular outcomes, such as a decrease in heart attacks, or a decrease in strokes.

Association of bariatric surgery with skin cancer incidence in adults with obesity: A nonrandomized controlled trial

6 October 2020

Fertility and pregnancy outcomes in women with polycystic ovary syndrome following bariatric surgery

25 August 2020

Conceiving a child is a fairly common reason for a woman to consider weight loss surgery.  There are lots of different causes for female infertility and some of them are directly related to obesity.  Polycystic ovaries is one of them.  From this study we can deduce that if the primary reason for infertility is PCOS then having weight loss surgery - which is the best 'treatment' for PCOS - can significantly increase the chances of conceiving and going on to have a successful pregnancy. For women considering IVF who are overweight or have known PCOS, bariatric surgery may actually be the most effective option.  Worthwhile discussing it with your GP, fertility specialist or … me!

Look forward to it.

Steph

Researchers conducted this unicenter cohort study to analyze fertility and gestational outcomes in women with polycystic ovary syndrome (PCOS) following bariatric surgery. For this analysis, 216 premenopausal women were screened for PCOS prior to bariatric surgery. From 2005 to 2015, all participants had bariatric surgery. Pregnancy rates for women seeking fertility were 95.2% in PCOS and 76.9% in controls and live birth rates were 81.0% and 69.2%, respectively. The time after surgery to reach the first pregnancy was 34 ± 28 months in women with PCOS, and 32 ± 25 months in controls. There were rare maternal and neonatal complications, with no differences between groups. Pregnancy and fertility rates were high in very obese women with PCOS after bariatric surgery, with few maternal and neonatal complications.