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Obesity and Cancer: the Profile of a Population who Underwent Bariatric Surgery

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Abstract

Introduction

Obesity is a significant risk factor for cancer incidence and mortality. The number of patients with obesity who undergo bariatric surgery is increasing; however, the impact of such a procedure in affecting the risk of cancer is not completely understood yet.

Methods

We conducted a retrospective unicentric cohort study to characterize the occurrence of cancer in patients who underwent bariatric surgery from January 2010 to December 2018. For cases of cancer identified after bariatric surgery, we performed a cancer-free survival analysis over time. We also performed a cross-sectional analysis of demographic and clinical characteristics at the time of surgery and compared patients with or without a cancer diagnosis.

Results

Of the 2578 patients who underwent bariatric surgery, 117 patients (4.5%) were diagnosed with a cancer. Fifty-nine cases were diagnosed before surgery, and the remaining 58 cases occurred after the bariatric procedure. The prevalence of cancer was more accentuated in women (4.9%) than among men (2.7%). Thyroid and breast cancer were the most frequent before and after bariatric surgery, respectively. On average, patients with cancer diagnosis were older (49.0 vs 43.3 years, p<0.001) and with a lower level of education (7.4 vs 8.6 school years, p=0.002).

Conclusion

Almost all the cases of cancer identified in this study were obesity-related cancers. Further prospective studies are needed to extend the current knowledge regarding the cancer risk profile of patients who undergo bariatric surgery.

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Acknowledgements

We would like to thank the following members of the CRIO Group for their valuable contributions: Ana Varela, André Pinho, Carla Galego, Cidália Gil, Cristina Martins, Diva Melim, Eduardo Lima da Costa, Eduardo Pinto, Eva Lau, Flora Correia, Hugo Sousa, Inês Magalhães, Isabel Brandão, Luís Miguel Pereira, Marco Silva, Patrícia Nunes, Selma Souto, and Sertório Manuel Andrade. We would also like to acknowledge the support of Daniela Salazar, Fernando Mendonça, João Sérgio Neves, Jorge Pedro, Maria João Ferreira, Maria Manuel Silva, Marta Canha, and Vanessa Guerreiro.

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Authors and Affiliations

  1. Faculdade de Medicina, Universidade do Porto, Porto, Portugal

    Helena Brito, Davide Carvalho & Paula Freitas

  2. Instituto de Investigação e Inovação em Saúde (i3s), Universidade do Porto, Porto, Portugal

    Ana C. Santos, Davide Carvalho & Paula Freitas

  3. EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal

    Ana C. Santos

  4. Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Porto, Portugal

    Ana C. Santos

  5. Departamento de Ciências da Saúde Pública e Forenses e Educação Médica, Faculdade de Medicina, Universidade do Porto, Porto, Portugal

    Ana C. Santos

  6. Centro de Responsabilidade Integrado de Obesidade (CRIO), Centro Hospitalar Universitário de São João, Porto, Portugal

    John Preto & Paula Freitas

  7. Serviço de Endocrinologia, Diabetes e Metabolismo, Centro Hospitalar Universitário de São João, Porto, Portugal

    Davide Carvalho & Paula Freitas

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  1. Helena Brito
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Correspondence to Helena Brito.

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Key Points

•Patients with obesity are at greater risk of having cancer.

•Thyroid and breast cancer were the most frequent before and after bariatric surgery, respectively.

•Cancer risk after bariatric surgery could depend on the procedure undergone, the patient’s gender, and the type of cancer.

•Further studies with long-term follow-up need to be carried out in bariatric populations.

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Brito, H., Santos, A.C., Preto, J. et al. Obesity and Cancer: the Profile of a Population who Underwent Bariatric Surgery. OBES SURG 31, 4682–4691 (2021). https://doi.org/10.1007/s11695-021-05626-0

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