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New Population Study Confirms Cancer Risk Reduction with Metabolic Surgery

Posted on: 26th Jul, 2019

Obese individuals suffer an increased risk of cancer, and an increase in cancer mortality compared to non-obese Americans. Now a large population-based study confirms that cancer incidence drops dramatically after metabolic surgery.

Numerous cohort studies have shown metabolic surgery decreases cancer risk. A previous large-scale prospectively matched 10-year surgical intervention trial identified that patients undergoing bariatric surgery had a significantly reduced risk of developing cancer (HR 0.67; 95% CI 0.53–0.85; p = 0.0009). The Swedish Obese Subjects study reinforced those findings. But the recent Wiggins meta-analysis paper involving over 635,000 patients represents the most conclusive analysis using population-based cohort studies. Among individual cancer types, breast cancer reduction was significant and pronounced as depicted below.

Obesity-related cancer is often defined as cancer of the breast, prostate, colorectum, endometrium, ovary, kidney, esophagus (adenocarcinoma only), liver, pancreas, gallbladder, non-Hodgkin lymphoma, leukemia, and thyroid. There is cohort data supporting this list but cohort, mechanism, and now population studies demonstrate breast cancer reduction from metabolic surgery and aggregate all cancer.
 
The mechanisms responsible for the reduction in cancer incidence associated with bariatric surgery are believed to be multifactoral. This effect is believed to be related to reduced systemic inflammation and oxidative stress, as well as the influence of surgery upon insulin resistance, sex steroids, gut hormones, and adipokines.
 
Metabolic surgery today consists of a 45-minute procedure with 4 Band-aids that is safer than Caesarian section and most routine operations, and it is safer than pharmaceutical management of type 2 diabetes in several large cohort papers.
 
 
References:
Sjöström, L., Gummesson, A., Sjöström, C.D., Narbro, K., Peltonen, M., Wedel, H., Bengtsson, C., Bouchard, C., Carlsson, B., Dahlgren, S. and Jacobson, P., 2009. Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. The lancet oncology, 10(7), pp.653-662.
 
Wiggins, T., Antonowicz, S.S. and Markar, S.R., 2019. Cancer Risk Following Bariatric Surgery—Systematic Review and Meta-analysis of National Population-Based Cohort Studies. Obesity surgery, 29(3), pp.1031-1039.

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