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Can Cancer Risk Be Melted Away Along with Excess Body Fat?

Summary and Comment |
June 24, 2009

Can Cancer Risk Be Melted Away Along with Excess Body Fat?

  1. Anna Wald, MD, MPH

Women who underwent bariatric surgery had substantially lower risk for cancer.

  1. Anna Wald, MD, MPH

In addition to its adverse metabolic and cardiovascular effects, obesity is associated with excess risk for cancer. In a prospective study, investigators in Sweden followed 2010 obese patients (1420 of whom were women; BMI ≥38 kg/m2) who underwent bariatric surgery and 2037 obese controls (1447 of whom were women) who received standard care and who were matched with surgical patients for factors such as age, weight, and smoking status. Surgery resulted in sustained mean weight loss of 20 kg; effects on overall incidence of fatal and nonfatal cancer (based on Swedish National Cancer Registry data) were evaluated in >99% of participants during a median follow-up of 11 years.

Overall, patients who underwent bariatric surgery had a lower risk for incident cancer than did control patients (hazard ratio, 0.67; P<0.001). This beneficial effect was observed in women (HR, 0.58; P=0.0001) but not in men (HR, 0.97); it was seen for various types of cancer and in association with all surgical techniques. Of note, reduction in cancer risk was not related to amount of weight lost.

Comment

These important results add to the evidence that obesity is a risk factor for cancer and suggest that substantial weight loss can partially mitigate this risk. Because this was not a randomized clinical trial, the data are not definitive. However, the large number of participants, high degree of retention, consistent ascertainment of malignancy, and long follow-up all strengthen the conclusions. Those patients who chose to undergo bariatric surgery might have had other socioeconomic attributes that influence cancer incidence, which could help explain why the amount of weight loss was not linked to reduction in cancer risk. Nonetheless, the data are intriguing and well worth discussing with patients who are considering weight-loss surgery.

Citation(s):

Reader Comments (2)

Alwin C. Lewis

Need patients any more reasons to lose weight? And the best way to lose weight is to reduce the amount of food you eat--dramatically!

Competing interests: Founder of The Slimming Station.

Bruce J Relyea

This is a well written article. As stated, because this was not a randomized clinical trial, the data are not definitive. Also as mentioned, the reason that reduction in cancer risk was not related to the amount of weight lost may have been related to other socioeconomic attributes in the operated group.

Competing interests: None declared

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