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减重手术对癌症风险的影响:来自荟萃分析的证据。

Effects of Bariatric Surgery on Cancer Risk: Evidence from Meta-analysis.

机构信息

Department of Forensic Pathology, West China School of BasicMedical Sciences & Forensic Medicine, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.

West China hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.

出版信息

Obes Surg. 2020 Apr;30(4):1265-1272. doi: 10.1007/s11695-019-04368-4.

Abstract

INTRODUCTION

Weight loss after bariatric surgery yields important health benefits. A multitude of observational studies have investigated the association of bariatric surgery for severe obesity with the risk of cancer. However, the results were debatable. The aim of the present study was to estimate the effect of bariatric surgery on overall cancer risk.

METHODS

A systematic literature search was performed to identify studies evaluating the association of bariatric surgery for severe obesity with the risk of cancer. Meta-analysis was performed to calculate combined prevalence.

RESULTS

Twenty-one cohort studies with 304,516 patients with obesity having under gone bariatric surgery and 8,492,408 patients with obesity as controls were included. Meta-analysis found decreased cancer risk to be associated with bariatric surgery (OR = 0.56, 95% CI = 0.48-0.66), both for the incidence of cancer (OR = 0.56, 95% CI = 0.46-0.68) and mortality of cancer (OR = 0.56, 95% CI = 0.41-0.75). In subgroup analysis, bariatric surgery was significantly associated with decreased breast cancer risk and endometrial cancer risk, but not associated with other cancer risk.

CONCLUSIONS

Our meta-analysis indicated that bariatric surgery for severe obesity was associated with decreased cancer risk, both for cancer incidence and mortality. Moreover, further studies estimating the functional effect and side effects may eventually provide a better, comprehensive understanding.

摘要

简介

减重手术可带来重要的健康益处。大量观察性研究调查了严重肥胖患者接受减重手术与癌症风险的关系。然而,结果存在争议。本研究旨在评估减重手术对整体癌症风险的影响。

方法

系统地检索了评估严重肥胖患者接受减重手术与癌症风险关联的研究。进行荟萃分析以计算综合患病率。

结果

纳入了 21 项队列研究,共 304516 例肥胖患者接受了减重手术,8492408 例肥胖患者作为对照。荟萃分析发现,减重手术与癌症风险降低相关(OR=0.56,95%CI=0.48-0.66),包括癌症发生率(OR=0.56,95%CI=0.46-0.68)和癌症死亡率(OR=0.56,95%CI=0.41-0.75)。亚组分析显示,减重手术与乳腺癌风险和子宫内膜癌风险降低显著相关,但与其他癌症风险无关。

结论

我们的荟萃分析表明,严重肥胖患者接受减重手术与癌症风险降低相关,无论是癌症发生率还是死亡率。此外,进一步估计功能效果和副作用的研究可能最终提供更好、更全面的认识。

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