Background

According CDC's latest report, overweight and obesity-related cancers accounted for 40% of all malignancies diagnosed in 2014.The aim of this study is to determine the impact of bariatric surgery(BS) in the prevention of cancer in patients with obesity.

Methods

The National inpatient sample(NIS) data collected between 2010 and 2014 was examined. Patients with previous diagnosis of cancer were excluded from the analysis.The population was classified as case and control-group. Case-subjects were defined as patients who underwent BS and control-subjects as patients with BMI≥35 who did not undergo BS.A Multivariate logistic regression model was performed to assess differences between case and control-group and adjust for independent variables as smoking-history and family-history-of-malignancy.All percentages and means(SE) were weighted.

Results

A total of 1,670,035 patients(1,423,367controls and 246,668cases) were included in the analysis. Patients without BS and with BMI≥35 were significantly more likely to experience cancer compared to patients who did not undergo BS(Adjusted OR=1.21,p<0.0001;Unadjusted OR=1.35,p<0.0001).Interestingly, we observed that patients with genetic predisposition to breast cancer and BMI>35 who did not undergo BS, had almost 2.5times higher rate of breast malignancy compared to patients with same predisposition in the case-group(18.0%,n=28 vs. 7.4%,n=3, p=0.0991).

Conclusions

Our findings suggest BS could significantly prevent the development of cancer in patients with higher risk than the average population. Additionally, to the best of our knowledge, this is the first study suggesting BS could decrease the rate of breast cancer in genetically-predisposed patients.Prospective studies in patients with genetic predisposition to breast cancer are needed to further assess this finding.