According to recent research, it has been observed by the investigators at the Division of Gastroenterology and Hepatology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey that bariatric surgery was associated with significant reductions in the risks of any cancer and obesity-related cancer in Nonalcoholic Fatty Liver Disease (NAFLD) patients with severe obesity.
The study is published in the Journal of Gastroenterology.
Nonalcoholic fatty liver disease (NAFLD) is associated with obesity and increased risk of cancer. The impacts of bariatric surgery on cancer risk in NAFLD patients are unknown.
Therefore, Vinod K. Rustgi and colleagues conducted the present study to investigate the effect of bariatric surgery on cancer risk in patients with NAFLD and severe obesity using the Marketscan database.
The authors conducted a retrospective cohort study of 18 to 64 years old newly diagnosed NAFLD patients with severe obesity. Cox proportional hazard models were used to examine the association between bariatric surgery, modeled as a time-varying covariate, and the risks of any cancer and obesity-related cancer, while accounting for confounding using inverse probability of treatment weighting (IPTW).
A total of the 98,090 patients were included in the study, 33,435 (34.1%) received bariatric surgery. In those without surgery,1,898 incident cases of cancer occurred over 115,890.11 person-years of follow-up, compared with 925 cancer cases over 67,389.82 person-years among surgery patients (crude rate ratio 0.84; 95% CI: 0.77 to 0.91)
The results showed that-
a. The IPTW-adjusted risk of any cancer and obesity-related cancer was reduced by 18% (hazard ratio [HR] 0.82; 95% CI, 0.76-0.89) and 25% (HR 0.65; 95% CI 0.56-0.75), respectively, in patients with versus without bariatric surgery.
b. The adjusted risks of any cancer and obesity-related cancer were significantly lower in cirrhotic versus non-cirrhotic patients who underwent surgery.
c. In cancer-specific models, bariatric surgery was associated with significant risk reductions for colorectal, pancreatic, endometrial, thyroid cancers, hepatocellular carcinoma, and multiple myeloma.
Hence, it was further concluded that "Bariatric surgery was associated with significant reductions in the risks of any cancer and obesity-related cancer in NAFLD patients with severe obesity."