Weight loss with bariatric surgery associated with lower risk of cancer and cancer-related mortality

A Cleveland Clinic study shows that in obese adults, weight loss achieved through bariatric surgery was associated with a 32% lower risk of developing cancer and a 48% lower risk of cancer-related death. compared to adults who did not have surgery. The research is published by JAMA.

About 42% of American adults suffer from obesity, according to the Centers for Disease Control and Prevention (CDC). Obesity increases the risk of developing 13 types of cancer that account for 40% of all cancers diagnosed each year in the United States, according to the CDC.

Ali Aminian, MD, lead study author and director of the Cleveland Clinic’s Bariatric & Metabolic Institute, said bariatric surgery is currently the most effective treatment for obesity. “Patients can lose 20-40% of their body weight after surgery, and the weight loss can be sustained for decades. The striking results of this study indicate that the greater the weight loss, the greater the risk of cancer is low,” said Dr. Aminian. .

The SPLENDID (Surgical Procedures and Long-term Effectiveness in Neoplastic Disease Incidence and Death) research is a matched cohort study that included more than 30,000 patients from the Cleveland Clinic. A group of 5,053 obese adult patients who underwent bariatric surgery between 2004 and 2017 were matched 1:5 to a control group of 25,265 patients who did not have surgery for their obesity.

After 10 years, 2.9% of patients in the bariatric surgery group and 4.9% of patients in the non-surgical group developed cancer associated with obesity. The International Agency for Research on Cancer describes 13 types of cancer as cancers associated with obesity, such as endometrial cancer, postmenopausal breast cancer, and cancers of the colon, liver, pancreas, ovaries and thyroid.

After 10 years, 0.8% of patients in the surgery group and 1.4% of patients in the non-surgical group died of cancer. These results indicate that bariatric surgery is associated with a 48% reduction in the risk of dying from cancer.

The researchers noted that the benefits of bariatric surgery were seen in a wide range of study participants, including women and men, young and elderly patients, as well as black and white patients. Additionally, benefits were similarly observed after gastric bypass and gastric sleeve operations.

According to the American Cancer Society, obesity is second only to smoking as a preventable cause of cancer in the United States. This study provides the best possible evidence on the value of intentional weight loss in reducing cancer risk and mortality.”

Steven Nissen, MD, Study Lead Author, Academic Director of the Heart, Vascular, and Thoracic Institute

Many studies have shown the health benefits of bariatric surgery or weight loss in obese patients. The Cleveland Clinic-led STAMPEDE study showed that after bariatric surgery, significant weight loss and control of type 2 diabetes last over time. The SPLENDOR study showed that in patients with fatty liver disease, bariatric surgery decreases the risk of liver disease progression and serious cardiac complications.

The SPLENDID study adds important findings to the literature focused on the link between obesity and cancer. Given the growing obesity epidemic worldwide, these findings have significant implications for public health.

“Based on the magnitude of the benefits demonstrated in our study, weight loss surgery may be considered in addition to other interventions that may help prevent cancer and reduce mortality,” said Jame Abraham, MD. , chairman of the Department of Hematology and Medical Oncology at the Cleveland Clinic. . “Further research needs to be conducted to understand the underlying mechanisms responsible for the reduction in cancer risk after bariatric surgery.”


Journal reference:

Ali Aminian, T., et al. (2022) Association of bariatric surgery with cancer risk and mortality in obese adults. JAMA. doi.org/10.1001/jama.2022.9009.

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