Department of General Surgery and the Bariatric and Metabolic Institute, Cleveland Clinic, Weston, Florida.
ScienceRight Editing & Publishing, London, Ontario, Canada.
Surg Obes Relat Dis. 2020 Nov;16(11):1648-1654. doi: 10.1016/j.soard.2020.07.017. Epub 2020 Jul 28.
According to the U.S. Centers for Disease Control, cancers linked to overweight or obesity accounted for roughly 40% of all U.S. malignancies in 2014.
The primary aim of this epidemiologic study was to assess whether bariatric surgery might have any preventative role against obesity-linked cancers among individuals with obesity.
Hospitals across the United States participating in the National Inpatient Sample database, created, updated, and monitored by the U.S. Healthcare Cost and Utilization Project.
National Inpatient Sample data collected from 2010 to 2014 were examined to identify any difference in the number of first cancer-related hospitalizations, as a proxy for cancer incidence, between patients with a history of prior bariatric surgery (cases) and those without (controls). Patients with any prior cancer diagnosis were excluded. To match the body mass index ≥35 kg/m generally required for bariatric surgery, all controls had to have a body mass index ≥35 kg/m. International Classification of Diseases-9 codes were employed to identify admissions for 13 obesity-linked cancers. Multivariate logistic regression analysis was performed to identify any case-control differences, after matching for all baseline demographic, co-morbidity, and cancer risk-factor variables. All percentages and means (with confidence intervals) were weighted, per Healthcare Cost and Utilization Project guidelines.
Among 1,590,579 controls and 247,015 bariatric surgery cases, there were 29,822 (1.93%; 95% confidence interval 1.91-1.96) and 3540 (1.43%; 1.38-1.47) first hospitalizations for cancer (adjusted odds ratio 1.17; 1.13-1.23; P < .0001).
Preliminary findings from a large U.S. database suggest that bariatric surgery may reduce the incidence of cancer in patients considered at high risk because of severe obesity.
根据美国疾病控制与预防中心的数据，2014 年，与超重或肥胖相关的癌症占美国所有恶性肿瘤的 40%左右。
本项流行病学研究的主要目的是评估肥胖症患者接受减重手术是否对肥胖相关癌症具有预防作用。
该研究在美国参与国家住院患者样本数据库的各个医院进行，该数据库由美国医疗保健成本和利用项目创建、更新和监测。
从 2010 年至 2014 年收集国家住院患者样本数据，以确定有或无减重手术史患者（病例组和对照组）首次癌症相关住院人数（作为癌症发病率的替代指标）是否存在差异。所有有既往癌症诊断的患者均被排除在外。为了匹配通常需要进行减重手术的体重指数（BMI）≥35kg/m²，所有对照组患者的 BMI 必须≥35kg/m²。采用国际疾病分类第 9 版代码识别 13 种肥胖相关癌症的入院病例。采用多变量逻辑回归分析，在匹配所有基线人口统计学、合并症和癌症风险因素变量后，确定病例组和对照组之间的差异。根据医疗保健成本和利用项目指南，所有百分比和平均值（置信区间）均进行了加权处理。
在 1590579 名对照组患者和 247015 名接受减重手术的病例中，有 29822 例（1.93%；95%置信区间 1.91-1.96）和 3540 例（1.43%；1.38-1.47）首次因癌症住院（校正后的比值比 1.17；1.13-1.23；P<.0001）。
来自美国大型数据库的初步研究结果表明，对于因严重肥胖而被认为处于高风险的患者，减重手术可能会降低癌症的发病率。
