Development of cancer after bariatric surgery.


Journal

Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
ISSN: 1878-7533
Titre abrégé: Surg Obes Relat Dis
Pays: United States
ID NLM: 101233161

Informations de publication

Date de publication:
Oct 2020
Historique:
received: 04 05 2020
revised: 31 05 2020
accepted: 13 06 2020
pubmed: 2 8 2020
medline: 28 4 2021
entrez: 2 8 2020
Statut: ppublish

Résumé

Although bariatric surgery has been associated with a reduction in risk of obesity-related cancer, data on the effect of bariatric interventions on other cancers are limited. This study aimed to examine the relationship between bariatric interventions and the incidence of various cancers after bariatric surgery. Administrative statewide database. The New York Statewide Planning and Research Cooperative System database was used to identify all adult patients diagnosed with obesity between 2006 and 2012 and patients who underwent bariatric procedures without preexisting cancer diagnosis and alcohol or tobacco use. Subsequent cancer diagnoses were captured up to 2016. Multivariable proportional subdistribution hazard regression analysis was performed to compare the risk of having cancer among obese patients with and without bariatric interventions. We identified 71,000 patients who underwent bariatric surgery and 323,197 patients without a bariatric intervention. Patients undergoing bariatric surgery were less likely to develop both obesity-related cancer (hazard ratio.91; 95% confidence interval, .85-.98; P = .013) and other cancers (hazard ratio .81; 95% confidence interval, .74-.89; P < .0001). Patients undergoing Roux-en-Y gastric bypass had a lower risk of developing cancers that are considered nonobesity related (hazard ratio .59; 95% confidence interval, .42-.83; P = .0029) compared with laparoscopic sleeve gastrectomy. Bariatric surgery is associated with a decreased risk of obesity-related cancers. More significantly, we demonstrated the relationship between bariatric surgery and the reduction of the risk of some previously designated nonobesity-related cancers, as well. Reclassification of nonobesity-related cancers and expansion of bariatric indications for reducing the risk of cancer may be warranted.

Sections du résumé

BACKGROUND BACKGROUND
Although bariatric surgery has been associated with a reduction in risk of obesity-related cancer, data on the effect of bariatric interventions on other cancers are limited.
OBJECTIVES OBJECTIVE
This study aimed to examine the relationship between bariatric interventions and the incidence of various cancers after bariatric surgery.
SETTING METHODS
Administrative statewide database.
METHODS METHODS
The New York Statewide Planning and Research Cooperative System database was used to identify all adult patients diagnosed with obesity between 2006 and 2012 and patients who underwent bariatric procedures without preexisting cancer diagnosis and alcohol or tobacco use. Subsequent cancer diagnoses were captured up to 2016. Multivariable proportional subdistribution hazard regression analysis was performed to compare the risk of having cancer among obese patients with and without bariatric interventions.
RESULTS RESULTS
We identified 71,000 patients who underwent bariatric surgery and 323,197 patients without a bariatric intervention. Patients undergoing bariatric surgery were less likely to develop both obesity-related cancer (hazard ratio.91; 95% confidence interval, .85-.98; P = .013) and other cancers (hazard ratio .81; 95% confidence interval, .74-.89; P < .0001). Patients undergoing Roux-en-Y gastric bypass had a lower risk of developing cancers that are considered nonobesity related (hazard ratio .59; 95% confidence interval, .42-.83; P = .0029) compared with laparoscopic sleeve gastrectomy.
CONCLUSIONS CONCLUSIONS
Bariatric surgery is associated with a decreased risk of obesity-related cancers. More significantly, we demonstrated the relationship between bariatric surgery and the reduction of the risk of some previously designated nonobesity-related cancers, as well. Reclassification of nonobesity-related cancers and expansion of bariatric indications for reducing the risk of cancer may be warranted.

Identifiants

pubmed: 32737010
pii: S1550-7289(20)30346-4
doi: 10.1016/j.soard.2020.06.026
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1586-1595

Informations de copyright

Copyright © 2020 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Auteurs

Stella T Tsui (ST)

Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York. Electronic address: stellatotsui@gmail.com.

Jie Yang (J)

Department of Family, Population and Preventive Medicine, Stony Brook University, Medical Center, Stony Brook, New York.

Xiaoyue Zhang (X)

Department of Family, Population and Preventive Medicine, Stony Brook University, Medical Center, Stony Brook, New York.

Salvatore Docimo (S)

Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York.

Konstantinos Spaniolas (K)

Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York.

Mark A Talamini (MA)

Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York.

Aaron R Sasson (AR)

Division of Surgical Oncology, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York.

Aurora D Pryor (AD)

Division of Bariatric, Foregut and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York.

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