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Although obesity is widely recognized as a cancer risk factor, few studies have shown that losing weight and maintaining that reduction reduces the risk
of developing certain cancers and possibly dying from certain cancers.
Although the underlying biological mechanisms are still not fully understood, many believe that obesity can stimulate cancer development and growth by causing increased inflammation, altering the microbiota, causing insulin resistance, and increasing levels of circulating insulin-like growth
factor, estrogen.
This article is the original of Translational Medicine Network, please indicate the source for reprinting
Written by Sophia
Research background
01
To investigate more deeply whether weight loss can reduce cancer risk and mortality, the researchers conducted surgical versus long-term efficacy studies of oncological morbidity and mortality, comparing adult obese patients undergoing bariatric surgery on CCHS with obese patients who had not undergone bariatric surgery for 17 years in an adult control group
.
The primary composite endpoint of this retrospective, observational, matched cohort study was the time to onset of one of 13 obesity-related cancers: esophageal adenocarcinoma, renal cell carcinoma, postmenopausal breast cancer, cardia cancer, and breast cancer
.
colon, rectum, liver, gallbladder, pancreas, ovaries, uterine body, or thyroid; and multiple myeloma
.
The secondary endpoint was cancer-related mortality
.
The study included 5053 obese adults
who underwent Roux-en-Y gastric bypass or sleeve gastrectomy at Cleveland Clinic Hospital between 2004 and 2017.
Each surgical patient was matched
to 5 patients who did not undergo bariatric surgery.
The 25,265 non-surgical control patients were selected by logistic regression models based on 10 potentially self-reported potential confounders, including: race (black, white, or other), body mass index (35-39.
9, 40-44.
9, 45-49.
9, 50–54.
9, 55–59.
9, or 60–80 kg/m 2), smoking history (never, before, or present), presence of type 2 diabetes, Elixhauser comorbidity index, Charlson comorbidities index and state of residence (classified as the sum of Florida or Ohio or other U.
S.
states).
The median age of patients is 46 years
.
Most were women (77%) and 73% were white
.
The median follow-up was 5.
8 years in the bariatric surgery group and 6.
1 years
in the non-surgical control group.
Study results
02
Studies show that the risk of developing 13 different types of cancer increases with obesity, and these cancers account for 40%
of all annual cancer diagnoses in the United States.
Over 10 years, the bariatric surgery group lost 19.
2% more body weight than the control group, which equates to a weight loss of 54.
7 pounds
.
The researchers also found that 96 patients in the bariatric surgery group and 780 patients in the non-surgical control group developed obesity-related cancers during a follow-up period from 17 to 21 years, resulting in a 10-year cumulative incidence of cancer of 2.
9% in the bariatric surgery group and 4.
9%
in the non-surgical control group.
In addition, 21 patients (0.
41%) in the bariatric surgery group and 205 patients (0.
81%) in the control group died from cancer-related causes; These rates correspond to 0.
6 and 1.
2 cancer-related deaths
per 1000 person-years follow-up, respectively.
That is, bariatric surgery patients had a 32% lower incidence of obesity-related cancer and a 48%
lower risk of cancer death compared to non-surgical control patients.
Research significance
03
According to the clinic's official report: the more weight you lose, the lower
your risk of cancer.
The findings also suggest that weight loss through bariatric surgery can reduce the risk of developing precancerous lesions such as endometrial hyperplasia, breast ductal carcinoma in situ, colorectal polyps, and Barret's esophagus
.
However, Dr.
Lauren R.
Teras noted that the study did not find that bariatric surgery reduced the risk of
breast cancer.
This may be due to the younger age of the participants, who entered the study at an average age of 46 years and had a median follow-up of about 6 years
.
The increased risk of breast cancer due to obesity is limited to postmenopausal breast cancer
.
Therefore, a study that includes older patients or patients with longer follow-up may show more favorable outcomes, including reduced breast cancer incidence and mortality
.
Dr.
McCullough noted that the criteria for evaluating who is a good candidate for bariatric surgery comes from many sources, including the American Society for Metabolic and Bariatric Surgery and the National Institute of Diabetes, Digestive and Kidney Diseases, and for general guidance on cancer prevention, clinicians can refer to the American Cancer Society's Diet and Physical Activity Cancer Prevention Guidelines
.
Resources:
https://acsjournals.
onlinelibrary.
wiley.
com/doi/10.
3322/caac.
21761
/guidelines.
html
Note: This article is intended to introduce the progress of medical research and cannot be used as a reference
for treatment options.
If you need health guidance, please go to a regular hospital
.
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