Long-Term Cancer Outcomes Following Bariatric Surgery: A Comparative Analysis of Surgical Procedures

Area of Science:

• Bariatric surgery outcomes
• Cancer epidemiology
• Surgical oncology

Background:

• Metabolic and bariatric surgery (MBS) is recognized for reducing cancer risk.
• However, the specific impact of different MBS procedures on cancer incidence requires further investigation.

Purpose of the Study:

• To investigate the association between four distinct MBS procedures and subsequent cancer incidence.
• To compare cancer risk across Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB), sleeve gastrectomy (SG), and duodenal switch (BPD-DS).

Main Methods:

• Utilized linked data from bariatric surgery and statewide cancer registries (1979-2018).
• Included 27,092 adult patients (BMI ≥ 30 kg/m²).
• Employed Cox proportional hazards regression to analyze MBS procedure type and cancer incidence.

Main Results:

• Roux-en-Y gastric bypass (RYGB) was performed in 75% of patients.
• Compared to RYGB, adjustable gastric banding (AGB) (HR=1.26, p=0.03) and duodenal switch (BPD-DS) (HR=1.91, p<0.01) were associated with significantly higher cancer hazards.
• Sleeve gastrectomy (SG) showed no significant difference in cancer hazard (HR=1.17, p=0.33).

Conclusions:

• Adjustable gastric banding (AGB) and duodenal switch (BPD-DS) may be linked to increased cancer risks relative to Roux-en-Y gastric bypass (RYGB).
• Further large-scale studies are necessary to elucidate long-term cancer risks and underlying mechanisms for various MBS types.