Bariatric surgery cuts cancer risk in obese NAFLD patients

18 Jul 2021
Bariatric surgery cuts cancer risk in obese NAFLD patients

Bariatric surgery reduces the risk of cancer in nonalcoholic fatty liver disease (NAFLD) patients with severe obesity, a recent study has found.

Researchers conducted a retrospective study of 98,090 NAFLD patients with severe obesity, of whom 34.1 percent (n=33,435) underwent bariatric surgery. Primary study outcomes were incident diagnoses of any cancer or obesity-related cancer.

Over 115,890.11 person-years of follow-up, 1,898 cases of incident cancer developed in the no-surgery group, as opposed to only 925 incident cases over 67,389.82 person-years in the surgery group. The resulting crude rate ratio (RR) was 0.84 (95 percent confidence interval [CI], 0.77–0.91), suggesting that bariatric surgery could protect from cancer.

The incidence rate of obesity-related malignancies was likewise lower in NAFLD patients who did vs did not undergo bariatric surgery (3.83 vs 5.64 per 1,000 person-years; crude RR, 0.68, 95 percent CI, 0.59–0.78).

Adjusted Cox proportional hazard regression analyses confirmed the protective effect of bariatric surgery, which significantly reduced the risk of any cancer by 18 percent (hazard ratio [HR], 0.82, 95 percent CI, 0.75–0.89) and of obesity-related cancer by 35 percent (HR, 0.65, 95 percent CI, 0.56–0.75).

The effect of bariatric surgery on both outcomes remained significant in both sexes and across several age groups.

“Though bariatric surgery is a more aggressive approach than lifestyle modifications, surgery may provide additional benefits such as improved quality of life and decreased long-term healthcare costs,” the researchers said.

Gastroenterology 2021;161:171-184.e10