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Bariatric surgery cuts cancer risk for some people with obesity

Bariatric surgery was associated with significant risk reductions in several obesity-related cancers, including colorectal and pancreatic cancers.

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Bariatric surgery can significantly reduce the risk of cancer—especially obesity-related cancers—by as much as half in certain people, a new study shows.

The research, published in the journal Gastroenterology, is the first to show bariatric surgery significantly decreases the risk of cancer in people with severe obesity and nonalcoholic fatty liver disease (NAFLD). The risk reduction is even more pronounced in people with NAFLD-cirrhosis, the researchers say.

“Though bariatric surgery is a more aggressive approach than lifestyle modifications, surgery may provide additional benefits…”

“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,” says study author Vinod K. Rustgi, professor of medicine, clinical director of hepatology, and director of the Center for Liver Diseases and Liver Masses at the Robert Wood Johnson Medical School at Rutgers University.

“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%, with the risk for obesity-related cancers being reduced by 25%. When comparing cirrhotic versus non-cirrhotic patients, cancer risk was reduced by 38% and 52%, respectively.”

The retrospective study looked at de-identified claims data of more than 98,000 privately insured people age 18 to 64 years old diagnosed with severe obesity and NAFLD between 2007 and 2017. Of those, more than a third (34.1%) subsequently had bariatric surgery.

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

The study results offer practical insight for clinicians and building blocks for future studies on the connection between NAFLD and cancer, Rustgi says.

“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 is to explore whether this reduced cancer risk holds true for people with severe obesity who do not have NAFLD. Researchers also plan to study how this reduced risk occurs—whether factors such as hormonal changes induced by weight loss are the cause of reduced cancer risk, rather than just the weight loss itself, Rustgi says.

In addition, researchers currently are studying the impact of bariatric surgery on cardiovascular outcomes, such as a decrease in heart attacks, or a decrease in strokes.

Source: Rutgers University

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