May 1, 2023 – Weight loss surgery has long been known to provide health benefits beyond the actual pounds lost. Diabetes can go into remission, sleep apnea can improve, and blood pressure can drop, research has shown. Now researchers are adding a lower cancer risk to the list.
The researchers compared nearly 56,000 obese people who had bariatric surgery with the same number who did not. They tracked how many people developed cancer over the next 10 years.
The surgery group had less than half the cancer cases.
“We saw a difference in the incidence of breast cancer, colon cancer, liver cancer and ovarian cancer…with patients in the bariatric surgery group having a lower incidence of these four types of cancer compared to the group non-surgical control,” Vibhu said. Chittajallu, MD, lead author of the study and a gastroenterology fellow at Cleveland University Hospitals.
Obesity has been associated with multiple serious diseases, including type 2 diabetes, heart disease, and cancer. The obesity epidemic is “one of the most serious health challenges in the US today,” Chittajallu said during an April 27 media preview of research highlights for Health Week. Digestive Diseases 2023.
Obesity is also common. The CDC reports that almost 42% of American adults are obese, and the rates continue to rise.
Chittajallu and his colleagues identified 55,789 obese people who had the surgery and a control group of others who did not by using billing codes in a national database. Their retrospective observational study included people who underwent sleeve gastrectomy, gastric bypass, and gastric band procedures at one of 47 health care organizations across the country.
key results
They found that 4% of the surgery group and 8.9% of the no-surgery group developed cancer. The bariatric surgery group had fewer new cases of multiple cancers.
Development of cancer over 10 years
The researchers found significant declines in four specific obesity-related cancers: breast cancer, colon cancer, liver cancer, and ovarian cancer. Several other cancers were not significantly different between the groups, including renal, rectal, and endometrial cancers.
Why cancer risk decreases after obesity surgery is not fully understood, Chittajallu said, but bariatric surgery has been shown to reduce excess inflammation, raise insulin and moderate hormone levels.
| cancer type | # Cases After Surgery | # Cases Without Surgery |
|---|---|---|
| Mother | 501 | 751 |
| Colon | 201 | 360 |
| Liver | 969 | 2,198 |
| Pancreatic | 54 | 86 |
| ovarian | 130 | 214 |
| Thyroid | 154 | 175 |
‘Makes logical sense’
Loren Laine, MD, moderator of the press conference, described the study as “fascinating.”
“Obesity is clearly associated with several different types of cancer and that is very important. So it makes logical sense that if you lose weight, you’ll reduce that risk,” said Laine, a professor of medicine and chief of digestive health at Yale University School of Medicine in New Haven, CT.
The researchers controlled for risk factors that could also contribute to cancer development, including a history of smoking, alcohol use, heart disease and hormone therapies. Laine added that the researchers probably couldn’t control for all factors because they were limited to the information available in the database.
Questions without answer
If future research shows that the more weight you lose, the more likely the cancer is to shrink, “it would be exciting,” Laine said. Also, it would be interesting to know if other approaches, such as weight-loss drugs, could also decrease the number of cancers.
“We need more research to understand how bariatric surgery affects cancer risk,” Chittajallu said, “but the significant findings from this study suggest it is an exciting avenue for further study.”
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