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Published in: Obesity Surgery 3/2019

Open Access 01-03-2019 | Review Article

Cancer Risk Following Bariatric Surgery—Systematic Review and Meta-analysis of National Population-Based Cohort Studies

Authors: Tom Wiggins, Stefan S Antonowicz, Sheraz R Markar

Published in: Obesity Surgery | Issue 3/2019

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Abstract

This study has analyzed results from registry-based population studies to assess the effect of bariatric surgery upon cancer incidence at a population level. Relevant studies were identified and meta-analysis was used to calculate pooled odds ratios (POR) for the incidence of cancer after bariatric surgery compared to controls. Eight population-based studies were included with 635,642 total patients. Bariatric surgery was associated with a significant reduction in overall cancer incidence (POR = 0.72; 95% CI 0.59 to 0.87; p = 0.0007) and incidence of obesity-related cancer (POR = 0.55; 95% CI 0.31 to 0.96; p = 0.04). Bariatric surgery was also protective for breast cancer development (POR = 0.50; 95% CI 0.25 to 0.99; p = 0.045). Bariatric surgery appears to be associated with a reduction in cancer incidence at a population-based level.
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Literature
3.
go back to reference Pischon T, Boeing H, Hoffmann K, et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med. 2008;359(20):2105–20.CrossRefPubMed Pischon T, Boeing H, Hoffmann K, et al. General and abdominal adiposity and risk of death in Europe. N Engl J Med. 2008;359(20):2105–20.CrossRefPubMed
4.
go back to reference Whitlock G, Lewington S, Sherliker P, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet (London, England). Elsevier. 2009;373(9669):1083–96.CrossRef Whitlock G, Lewington S, Sherliker P, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet (London, England). Elsevier. 2009;373(9669):1083–96.CrossRef
5.
go back to reference Zhang C, Rexrode KM, Van Dam RM, et al. Abdominal obesity and the risk of all-cause, cardiovascular, and cancer mortality: sixteen years of follow-up in US women. Circulation. 2008;117(13):1658–67.CrossRefPubMed Zhang C, Rexrode KM, Van Dam RM, et al. Abdominal obesity and the risk of all-cause, cardiovascular, and cancer mortality: sixteen years of follow-up in US women. Circulation. 2008;117(13):1658–67.CrossRefPubMed
6.
go back to reference Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804–14.CrossRefPubMed Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804–14.CrossRefPubMed
7.
go back to reference Renehan AG, Tyson M, Egger M, et al. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371:569–78.CrossRef Renehan AG, Tyson M, Egger M, et al. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371:569–78.CrossRef
8.
9.
go back to reference Steele CB, Thomas CC, Henley SJ, et al. Vital signs: trends in incidence of cancers associated with overweight and obesity — United States, 2005–2014. MMWR Morb Mortal Wkly Rep. 2017;66(39):1052–8.CrossRefPubMedPubMedCentral Steele CB, Thomas CC, Henley SJ, et al. Vital signs: trends in incidence of cancers associated with overweight and obesity — United States, 2005–2014. MMWR Morb Mortal Wkly Rep. 2017;66(39):1052–8.CrossRefPubMedPubMedCentral
10.
go back to reference Calle EE, Rodriguez C, Walker-Thurmond K, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348:1625–383.CrossRefPubMed Calle EE, Rodriguez C, Walker-Thurmond K, et al. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348:1625–383.CrossRefPubMed
11.
go back to reference Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.CrossRefPubMed Sjöström L, Narbro K, Sjöström CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.CrossRefPubMed
12.
go back to reference Sjöström L, Gummesson A, Sjöström CD, et al. Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. Lancet Oncol. 2009;10(7):653–62.CrossRefPubMed Sjöström L, Gummesson A, Sjöström CD, et al. Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. Lancet Oncol. 2009;10(7):653–62.CrossRefPubMed
13.
go back to reference Christou NV, Lieberman M, Sampalis F, et al. Bariatric surgery reduces cancer risk in morbidly obese patients. Surg Obes Relat Dis. American Society for Metabolic and Bariatric Surgery. 2008;4(6):691–5.CrossRefPubMed Christou NV, Lieberman M, Sampalis F, et al. Bariatric surgery reduces cancer risk in morbidly obese patients. Surg Obes Relat Dis. American Society for Metabolic and Bariatric Surgery. 2008;4(6):691–5.CrossRefPubMed
14.
go back to reference McCawley GM, Ferriss JS, Geffel D, et al. Cancer in obese women: potential protective impact of bariatric surgery. J Am Coll Surg. American College of Surgeons. 2009;208(6):1093–8.CrossRefPubMed McCawley GM, Ferriss JS, Geffel D, et al. Cancer in obese women: potential protective impact of bariatric surgery. J Am Coll Surg. American College of Surgeons. 2009;208(6):1093–8.CrossRefPubMed
15.
go back to reference Ward KK, Roncancio AM, Shah NR, et al. Bariatric surgery decreases the risk of uterine malignancy. Gynecol Oncol. 2014;133(1):63–6.CrossRefPubMed Ward KK, Roncancio AM, Shah NR, et al. Bariatric surgery decreases the risk of uterine malignancy. Gynecol Oncol. 2014;133(1):63–6.CrossRefPubMed
16.
go back to reference DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177–88.CrossRef DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986;7(3):177–88.CrossRef
17.
go back to reference Adams TD, Stroup AM, Gress RE, et al. Cancer incidence and mortality after gastric bypass surgery. Obesity. 2010;17(4):796–802.CrossRef Adams TD, Stroup AM, Gress RE, et al. Cancer incidence and mortality after gastric bypass surgery. Obesity. 2010;17(4):796–802.CrossRef
18.
go back to reference Derogar M, Hull MA, Kant P, et al. Increased risk of colorectal cancer after obesity surgery. Ann Surg. 2013;258(6):983–8.CrossRefPubMed Derogar M, Hull MA, Kant P, et al. Increased risk of colorectal cancer after obesity surgery. Ann Surg. 2013;258(6):983–8.CrossRefPubMed
19.
go back to reference Douglas IJ, Bhaskaran K, Batterham RL, et al. Bariatric surgery in the United Kingdom: a cohort study of weight loss and clinical outcomes in routine clinical care. PLoS Med. 2015;12(12):e1001925.CrossRefPubMedPubMedCentral Douglas IJ, Bhaskaran K, Batterham RL, et al. Bariatric surgery in the United Kingdom: a cohort study of weight loss and clinical outcomes in routine clinical care. PLoS Med. 2015;12(12):e1001925.CrossRefPubMedPubMedCentral
20.
go back to reference Gribsholt SB, Thomsen RW, Svensson E, et al. Overall and cause-specific mortality after Roux-en-Y gastric bypass surgery: a nationwide cohort study. Surg Obes Relat Dis. 2017;13(4):581–7.CrossRefPubMed Gribsholt SB, Thomsen RW, Svensson E, et al. Overall and cause-specific mortality after Roux-en-Y gastric bypass surgery: a nationwide cohort study. Surg Obes Relat Dis. 2017;13(4):581–7.CrossRefPubMed
21.
go back to reference Mackenzie H, Markar S, Askari A, Faiz O, Hull M, Purkayastha S, et al. Obesity surgery and cancer risk: an English population-based cohort study. Br J Surg. 2018. Mackenzie H, Markar S, Askari A, Faiz O, Hull M, Purkayastha S, et al. Obesity surgery and cancer risk: an English population-based cohort study. Br J Surg. 2018.
22.
go back to reference Maret-Ouda J, Tao W, Mattsson F, et al. Esophageal adenocarcinoma after obesity surgery in a population-based cohort study. Surg Obes Relat Dis. 2017;13(1):28–34.CrossRefPubMed Maret-Ouda J, Tao W, Mattsson F, et al. Esophageal adenocarcinoma after obesity surgery in a population-based cohort study. Surg Obes Relat Dis. 2017;13(1):28–34.CrossRefPubMed
23.
go back to reference Östlund MP, Lu Y, Lagergren J. Risk of obesity-related cancer after obesity surgery in a population-based cohort study. Ann Surg. 2010;252(6):972–6.CrossRefPubMed Östlund MP, Lu Y, Lagergren J. Risk of obesity-related cancer after obesity surgery in a population-based cohort study. Ann Surg. 2010;252(6):972–6.CrossRefPubMed
24.
go back to reference Schauer DP, Feigelson HS, Koebnick C, et al. Bariatric surgery and the risk of cancer in a large multisite cohort. Ann Surg. 2017;21:1.CrossRef Schauer DP, Feigelson HS, Koebnick C, et al. Bariatric surgery and the risk of cancer in a large multisite cohort. Ann Surg. 2017;21:1.CrossRef
26.
go back to reference Ashrafian H, Ahmed K, Rowland SP, et al. Metabolic surgery and cancer. Cancer. 2011;117(9):1788–99.CrossRefPubMed Ashrafian H, Ahmed K, Rowland SP, et al. Metabolic surgery and cancer. Cancer. 2011;117(9):1788–99.CrossRefPubMed
27.
go back to reference Tilg H, Moschen AR. Adipocytokines: mediators linking adipose tissue, inflammation and immunity. Nat Rev Immunol. 2006;6(10):772–83.CrossRefPubMed Tilg H, Moschen AR. Adipocytokines: mediators linking adipose tissue, inflammation and immunity. Nat Rev Immunol. 2006;6(10):772–83.CrossRefPubMed
28.
go back to reference Penney NC, Kinross J, Newton RC, et al. The role of bile acids in reducing the metabolic complications of obesity after bariatric surgery: a systematic review. Int J Obes. 2015;39(11):1565–74.CrossRef Penney NC, Kinross J, Newton RC, et al. The role of bile acids in reducing the metabolic complications of obesity after bariatric surgery: a systematic review. Int J Obes. 2015;39(11):1565–74.CrossRef
29.
go back to reference Kant P, Sainsbury A, Reed KR, et al. Rectal epithelial cell mitosis and expression of macrophage migration inhibitory factor are increased 3 years after Roux-en-Y gastric bypass (RYGB) for morbid obesity: implications for long-term neoplastic risk following RYGB. Gut. 2011;60(7):893–901.CrossRefPubMed Kant P, Sainsbury A, Reed KR, et al. Rectal epithelial cell mitosis and expression of macrophage migration inhibitory factor are increased 3 years after Roux-en-Y gastric bypass (RYGB) for morbid obesity: implications for long-term neoplastic risk following RYGB. Gut. 2011;60(7):893–901.CrossRefPubMed
30.
go back to reference Zhou X, Yu J, Li L, et al. Effects of bariatric surgery on mortality, cardiovascular events, and cancer outcomes in obese patients: systematic review and meta-analysis. Obes Surg. 2016;26(11):2590–601.CrossRefPubMed Zhou X, Yu J, Li L, et al. Effects of bariatric surgery on mortality, cardiovascular events, and cancer outcomes in obese patients: systematic review and meta-analysis. Obes Surg. 2016;26(11):2590–601.CrossRefPubMed
31.
go back to reference Casagrande DS, Rosa DD, Umpierre D, et al. Incidence of cancer following bariatric surgery: systematic review and meta-analysis. Obes Surg. 2014;24(9):1499–509.CrossRefPubMed Casagrande DS, Rosa DD, Umpierre D, et al. Incidence of cancer following bariatric surgery: systematic review and meta-analysis. Obes Surg. 2014;24(9):1499–509.CrossRefPubMed
Metadata
Title
Cancer Risk Following Bariatric Surgery—Systematic Review and Meta-analysis of National Population-Based Cohort Studies
Authors
Tom Wiggins
Stefan S Antonowicz
Sheraz R Markar
Publication date
01-03-2019
Publisher
Springer US
Published in
Obesity Surgery / Issue 3/2019
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-3501-8

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