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13.12.2018 15:09:46
The risk of hormonal tumours (breast, endometrial, prostate cancers) after bypass surgery, gastric banding and sleeve gastroplasty is reduced. However, after gastric bypass, the risk of getting colorectal cancer increases.
Obese patients have an increased risk of getting tumour diseases, in particular breast and endometrial cancers, as well as malignant colorectal tumours and oesophageal cancer. Surgical interventions to reduce excess weight are currently recognized methods. It has been proved that they improve the metabolism and cardiovascular system, as well as reduce the risk of mortality. An important question is whether surgical weight loss also reduces the risk of developing malignant tumours. According to the authors, the results of the research concerning this matter are ambiguous.
A group study was conducted based on the data provided by the British data service (period between 1997 and 2012). The risk of malignant tumours in 8794 patients who underwent bariatric surgery and the risk in 8794 non-operated patients with obesity were calculated. Intervention means gastric bypass, gastric banding and sleeve gastroplasty.
The calculations showed 77% less chance of developing hormonal tumours (beast, endometrial and prostate cancers) for operated patients.
The risk of breast cancer is reduced by 75%, endometrial carcinoma by 79%, and the risk of prostate cancer by 63%.
According to the calculations, gastric bypass gives the largest reduction in risk (84%). With sleeve gastroplasty, the reduction in risk is 79%, with gastric banding the risks are reduced by 66%.
However, in contrast to other surgical methods, gastric bypass surgery is associated with the highest risk of colorectal cancer. Statistical analysis has shown an increase in the risk of up to 163%.
This study has confirmed the findings of earlier studies, for example, the 2014 meta-analysis. Nevertheless, the evidence of the actual group research with retrospective data analysis is a bit limited, the authors point out. Thus, the lack of data prevented from calculating the correlation between the change in BMI and the incidence of tumour development. However, the difference between the reduction of the risk of hormone-induced tumours, on the one hand, and the increase in the risk of colorectal malignant tumours, on the other hand, is quite evident. It was not possible to calculate the risk of oesophageal cancer because of the low incidence of the disease. The exact risk reduction mechanism is not yet fully known. For example, there are debates about cancer protection in consequence of postoperative changes in the microflora.
On the whole, the results of this study have increased the significance of bariatric surgery for obesity. But indirectly, they have shown that medical support for patients does not end with the operation. The fact that after gastric bypass there are high risks of colorectal carcinoma suggests that after such operations it is necessary to pay particular attention to these malignant tumours.
