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Bariatric surgery and risk of postoperative endometrial cancer: a systematic review and meta-analysis
Sikarin Upala1, Anawin Sanguankeo1
1Department of Internal Medicine, Bassett Medical Center and Columbia University College of Physicians and Surgeons, Cooperstown, New York; Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Background:
Bariatric surgery is an essential intervention for severely obese patients who fail medical treatment. It has been linked to improvements in cardiovascular and cerebrovascular disease. However, its effect on endometrial cancer risk is still unknown. This is a systematic review and meta-analysis of available studies on bariatric surgery and risk of postoperative endometrial cancer. The objective of this study was to explore the association between bariatric surgery and endometrial cancer risk.
Methods:
A comprehensive search of the databases of PubMed/MEDLINE, EMBASE, and CENTRAL was performed from their dates of inception to July 2014. The inclusion criterion was articles on bariatric surgery and incidence of endometrial cancer after the procedure. Two authors independently assessed the quality of the articles and extracted the data.
Results:
From 159 full-text articles, 6 observational studies met the inclusion criterion, and 3 studies involving 890,110 participants were included in the meta-analysis based on the random effects model. There was a reduced risk of endometrial cancer postoperatively in those receiving bariatric surgery compared with controls with pooled relative risk = .40 (95% CI: .20-.79).
Conclusions:
Bariatric surgery is associated with a reduced risk of endometrial cancer after the procedure. However, more randomized controlled studies are needed to provide better quality of evidence.
