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Date: February 1, 2024
Bariatric surgery, a highly effective treatment for obesity, may decrease the risk of certain cancers while potentially increasing the risk of others, according to a comprehensive scientific review published in JAMA Surgery. The review underscores the need for further research and caution before drawing definitive conclusions about the procedure’s impact on cancer risk.
Bariatric surgery has long been regarded as an evidence-based treatment for obesity, with proven benefits in improving various health outcomes, including heart disease, type 2 diabetes, and high blood pressure. As obesity is linked to an increased risk of several cancers, researchers have explored whether bariatric surgery could play a preventive role in cancer development.
However, the review reveals mixed findings on the association between bariatric surgery and cancer risk, emphasizing the heterogeneity and potential bias in existing studies. Dr. Zhi Ven Fong, a Surgical Oncologist at Mayo Clinic Arizona and the review’s author, stresses the need for more research to establish a clearer understanding of the relationship between bariatric surgery and different cancer types.
The review found consistent evidence supporting a reduction in the risk of hormone-related cancers, including breast, ovarian, and endometrial cancers, following bariatric surgery. Mechanisms for this reduction involve the impact of fat, specifically adipose tissue, on hormones such as estrogen and insulin.
In contrast, conflicting results were observed regarding other forms of cancer. Historical beliefs associating bariatric surgery with an increased risk of esophageal and gastric cancer were contradicted by the review, which found either similar or slightly improved cancer risk in these cases.
Pancreatic and liver cancer results were deemed inconsistent, and colorectal cancer findings were mixed. While some studies suggested an elevated risk of colorectal cancer post-surgery, others did not support this association.
Experts caution against drawing definitive conclusions from these findings. Dr. Cindy Kin, an Associate Professor of Surgery at Stanford Medicine, notes that the review underscores both positive and negative associations with certain cancer types and highlights a gray area where conflicting results exist.
Despite concerns about potential colorectal cancer risk, experts emphasize that the overall benefits of bariatric surgery outweigh the potential risks for eligible candidates. Dr. Dan Azagury, section chief of Minimally Invasive and Bariatric Surgery at Stanford Health, urges caution in interpreting the contradictory data on colorectal cancer and emphasizes the importance of considering the broader health benefits of bariatric surgery.
Bariatric surgery, also known as “weight loss surgery,” modifies the digestive system to reduce food intake and induce a feeling of fullness. While the procedure has demonstrated significant weight loss and long-term weight maintenance, its impact on cancer risk remains a complex and evolving area of study.
As the fight against the obesity epidemic continues, the review emphasizes the need for comprehensive discussions between healthcare providers and patients considering bariatric surgery, taking into account potential associations with cancer risk as part of the shared decision-making process.
