World Journal of Surgery

, Volume 33, Issue 10, pp 2028–2033

Cancer and Obesity: Effect of Bariatric Surgery

Article

Abstract

Recent international cancer prevention guidelines recommend weight loss, where appropriate, for the purpose of cancer risk reduction. However, limited research associates voluntary weight loss to subsequent cancer incidence because of the difficulty of achieving long-term weight loss maintenance among large participant groups. Bariatric surgery has demonstrated long-term sustained weight loss, and as a result, patients after bariatric surgery represent an ideal population to explore the relationship between long-term, voluntary weight loss and cancer incidence. This paper briefly reviews cancers that have shown to be associated with overweight and obesity and looks at studies that demonstrate reduced total mortality after bariatric surgery. Reduced cancer mortality and incidence as well as reduced cancer-related physician visits after bariatric surgery are presented. Study limitations and future research questions related to cancer and bariatric surgery are briefly discussed.

References

  1. 1.
    Food, Nutrition, Physical Activity, and the Prevention of Cancer: A Global Perspective (2007) World Cancer Research Fund/American Institute for Cancer Research, AICR, Washington, DCGoogle Scholar
  2. 2.
    Renehan A et al (2008) Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet 371(9612):569–578PubMedCrossRefGoogle Scholar
  3. 3.
    Reeves GK, Pirie K, Beral V, Green J, Spencer E, Bull D, Million Women Study Collaboration (2007) Cancer incidence and mortality in relation to body mass index in the Million Woman Study: cohort study. BMJ 335(7630):1134PubMedCrossRefGoogle Scholar
  4. 4.
    Calle E (2008) Obesity and cancer. In: Hu F (ed) Obesity epidemiology. Oxford University Press, Oxford, pp 196–215Google Scholar
  5. 5.
    Samanic C et al (2006) Relation of body mass index to cancer risk in 362, 552 Swedish men. Cancer Causes Control 17:901–909PubMedCrossRefGoogle Scholar
  6. 6.
    Calle EE et al (2003) Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med 348:1625–1638PubMedCrossRefGoogle Scholar
  7. 7.
    Rapp K et al (2005) Obesity and incidence of cancer: a large cohort study of over 145,000 adults in Austria. Br J Cancer 93:1062–1067PubMedCrossRefGoogle Scholar
  8. 8.
    International Agency for Research on Cancer (2002) IRAC Handbooks of Cancer Prevention. Weight control and physical activity. International Agency for Research on Cancer, LyonGoogle Scholar
  9. 9.
    Calle EE, Kaaks R (2004) Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer 4:579–591PubMedCrossRefGoogle Scholar
  10. 10.
    Parker E, Folsom A (2003) Intentional weight loss and incidence of obesity-related cancers: the Iowa Women’s Health Study. Int J Obes 27:1447–1452CrossRefGoogle Scholar
  11. 11.
    Rodriguez C et al (2007) Body mass index, weight change, and risk of prostate cancer in the Cancer Prevention Study II Nutrition Cohort. Cancer Epidemiol Biomarkers Prev 16:63–69PubMedCrossRefGoogle Scholar
  12. 12.
    Trentham-Dietz A et al (2006) Weight change and risk of endometrial cancer. Int J Epidemiol 35:151–158PubMedCrossRefGoogle Scholar
  13. 13.
    Calle EE, Thun MJ (2004) Obesity and cancer. Oncogene 23:6365–6378PubMedCrossRefGoogle Scholar
  14. 14.
    Webb P (2006) Commentary: weight gain, weight loss, and endometrial cancer. Int J Epidemiol 35:301–302CrossRefGoogle Scholar
  15. 15.
    Harvie M et al (2005) Association of gain and loss of weight before and after menopause with risk of postmenopausal breast cancer in the Iowa women’s health study. Cancer Epidemiol Biomarkers Prev 14:656–661PubMedCrossRefGoogle Scholar
  16. 16.
    Rajala MW, Scherer PE (2003) Minireview: the adipocyte—at the crossroads of energy homeostasis, inflammation, and atherosclerosis. Endocrinology 144:3765–3773PubMedCrossRefGoogle Scholar
  17. 17.
    Xu WH et al (2006) Weight history and risk of endometrial cancer among Chinese women. Int J Epidemiol 35:159–166PubMedCrossRefGoogle Scholar
  18. 18.
    National Institutes of Health (NHLBI) (1998) Clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults: the evidence report. Obes Res 6:51S–209SGoogle Scholar
  19. 19.
    Kushner RF, Noble CA (2006) Long-term outcome of bariatric surgery: an interim analysis. Mayo Clin Proc 81(10 Suppl):S46–S51PubMedGoogle Scholar
  20. 20.
    Pories WJ et al (1995) Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg 222:339–350PubMedCrossRefGoogle Scholar
  21. 21.
    Sjostrom L et al (2004) Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med 351:2683–2693PubMedCrossRefGoogle Scholar
  22. 22.
    IARC, IRAC Handbooks of Cancer Prevention (2002) Weight control and physical activity. International Agency for Research on Cancer, LyonGoogle Scholar
  23. 23.
    Rexrode KM et al (2003) Relationship of total and abdominal adiposity with CRP and IL-6 in women. Ann Epidemiol 13:674–682PubMedCrossRefGoogle Scholar
  24. 24.
    Loffreda S et al (1998) Leptin regulates proinflammatory immune responses. FASEB J 12:57–65PubMedGoogle Scholar
  25. 25.
    Suzuki R et al (2006) Body weight and postmenopausal breast cancer risk defined by estrogen and progesterone receptor status among Swedish women: a prospective cohort study. Int J Cancer 119:1683–1689PubMedCrossRefGoogle Scholar
  26. 26.
    Buchwald H et al (2004) Bariatric surgery: a systematic review and meta-analysis. JAMA 292:1724–1737PubMedCrossRefGoogle Scholar
  27. 27.
    Maggard MA et al (2005) Meta-analysis: surgical treatment of obesity. Ann Intern Med 142:547–559PubMedGoogle Scholar
  28. 28.
    Technology Evaluation Center (TEC) (2003) Special report: the relationship between weight loss and changes in morbidity following bariatric surgery for morbid obesity. Technol Eval Cent Asses Program 18:1–25Google Scholar
  29. 29.
    Colquitt J et al. (2005) Surgery for morbid obesity. Cochrane Database Syst Rev 2005(4):CD003641Google Scholar
  30. 30.
    Clegg AJ et al (2002) The clinical effectiveness and cost-effectiveness of surgery for people with morbid obesity: a systematic review and economic evaluation. Health Technol Assess 6:1–153PubMedGoogle Scholar
  31. 31.
    O’Brien PE et al (2006) Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program: a randomized trial. Ann Intern Med 144:625–633PubMedGoogle Scholar
  32. 32.
    Dixon JB et al (2008) Adjustable gastric banding and conventional therapy for type 2 diabetes: a randomized controlled trial. JAMA 299:316–323PubMedCrossRefGoogle Scholar
  33. 33.
    Dixon JB et al (2007) Changes in body composition with weight loss: obese subjects randomized to surgical and medical programs. Obesity (Silver Spring) 15:1187–1198CrossRefGoogle Scholar
  34. 34.
    Mingrone G et al (2002) Sex hormone-binding globulin levels and cardiovascular risk factors in morbidly obese subjects before and after weight reduction induced by diet or malabsorptive surgery. Atherosclerosis 161:455–462PubMedCrossRefGoogle Scholar
  35. 35.
    Christou NV et al (2004) Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg 240:416–423PubMedCrossRefGoogle Scholar
  36. 36.
    Sjostrom L et al (2007) Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med 357:741–752PubMedCrossRefGoogle Scholar
  37. 37.
    Adams TD et al (2007) Long-term mortality after gastric bypass surgery. N Engl J Med 357:753–761PubMedCrossRefGoogle Scholar
  38. 38.
    Flum DR, Dellinger EP (2004) Impact of gastric bypass operation on survival: a population-based analysis. J Am Coll Surg 199:543–551PubMedCrossRefGoogle Scholar
  39. 39.
    MacDonald KG Jr et al (1997) The gastric bypass operation reduces the progression and mortality of non-insulin-dependent diabetes mellitus. J Gastrointest Surg 1:213–220PubMedCrossRefGoogle Scholar
  40. 40.
    Sowemimo OA et al (2007) Natural history of morbid obesity without surgical intervention. Surg Obes Relat Dis 3:73–77PubMedCrossRefGoogle Scholar
  41. 41.
    Busetto L et al (2007) Comparative long-term mortality after laparoscopic adjustable gastric banding versus nonsurgical controls. Surg Obes Relat Dis 3:496–502PubMedCrossRefGoogle Scholar
  42. 42.
    Peeters A et al (2007) Substantial intentional weight loss and mortality in the severely obese. Ann Surg 246:1028–1033PubMedCrossRefGoogle Scholar
  43. 43.
    Omalu BI et al (2007) Death rates and causes of death after bariatric surgery for Pennsylvania residents, 1995 to 2004. Arch Surg 142:923–929PubMedCrossRefGoogle Scholar
  44. 44.
    Christou NV et al (2008) Bariatric surgery reduces cancer risk in morbidly obese patients. Surg Obes Relat Dis 4:691–695PubMedCrossRefGoogle Scholar
  45. 45.
    Adams TD, Stroup AM, Gress RE, Adams KF, Calle EE, Smith SC et al (2009) Cancer incidence and mortality after gastric bypass surgery. Obesity (Silver Spring) 17:796–802CrossRefGoogle Scholar
  46. 46.
    Reeves MJ et al (1996) Body mass and breast cancer. Relationship between method of detection and stage of disease. Cancer 77:301–307PubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2009

Authors and Affiliations

  1. 1.Cardiovascular Genetics DivisionUniversity of Utah School of MedicineSalt Lake CityUSA

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