Bariatric Surgery for Severe Obesity Reduces Cancer Risk: Presented at ECO

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Title: Bariatric Surgery for Severe Obesity Reduces Cancer Risk: Presented at ECO
URL: http://www.pslgroup.com/dg/221C9E.htm
Doctor's Guide
May 22, 2008

By Timothy A. O'Leary

GENEVA -- May 19, 2008 -- Bariatric surgery in patients with severe obesity is associated with a reduced overall risk for developing cancer, researchers reported here at the 16th European Congress on Obesity (ECO).

Researchers for the Swedish Obese Subjects (SOS) study followed 4,047 people with obesity since 1987. Of these subjects, 2,010 underwent bariatric surgery and 2,037 received "conventional treatment" (defined as low-calorie diets, lifestyle modifications, and pharmacological treatment).

The patients who underwent bariatric surgery achieved a sustained average weight reduction; by contrast, the average weight change in the control group was minimal.

During an average of 11 years of follow-up per patient, 126 of the surgical patients developed first-time cancers. The corresponding figure for the nonsurgical patients was 173.

A "significant" corresponding risk reduction of 29% was cited by Anders Gummesson, MD, Researcher, Department of Molecular and Clinical Medicine and Wallenberg Laboratory for Cardiovascular Research, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.

"Bariatric surgery for severe obesity is associated with a reduced overall risk of developing cancer," Dr. Gummesson stated here in an oral presentation on May 16. The risk reduction in women was 37%, he said, adding that "there was a clear treatment benefit in women."

"One out of 3 cancers in severely obese women could be avoided through bariatric surgery," Dr. Gummesson concluded.

The most common types of cancer in this study were breast cancer, endometrial cancer, colorectal cancer, haematopoietic cancers, and prostate cancer.

The unadjusted hazard ratio for overall cancer incidence was 0.71 (P = .003) for the surgery group compared with the control group. The corresponding hazard ratio adjusted for risk factors was 0.74 (P = .011).

When the 1,178 men and 2,867 women in the study were analysed separately, the unadjusted hazard ratios were .98 for men (95% confidence interval [CI], 0.63 - 1.51; P = .91) and 0.63 for women (95% CI, 0.48 - 0.82; P = .001).

Hazard ratios using specific cancer types as outcomes did not reach statistical significance.

The current cancer status was known for all but 3 subjects at the final analysis (December 31, 2005), providing a follow-up rate of 99.9%.

Prior to the start of the study, there were signs that weight loss could reduce the risk of cancer, but the evidence for this was lacking.

Bariatric surgery works by modifying the gastrointestinal tract, thereby reducing nutrient intake and absorption.

This study was funded by Hoffmann-La Roche Inc., AstraZeneca PLC, Cederroth International, and the Swedish Medical Research Council.

[Presentation title: Effects of Bariatric Surgery on Cancer Incidence in Swedish Obese Subjects. Abstract T2:OS3.6]

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