Desai Devashish, Singhal Sachi, Koka Jean
Internal Medicine, Crozer Keystone Health System, Upland, USA.
Internal Medicine, Crozer-Chester Medical Center, Upland, USA.
Cureus. 2022 Apr 9;14(4):e23976. doi: 10.7759/cureus.23976. eCollection 2022 Apr.
Purpose Obesity is a global pandemic that exerts a significant burden on healthcare worldwide. Multiple cancers, as well as deaths from the same, are more prevalent in obese patients. Bariatric surgery has been shown to be the most effective way of treating obesity once other measures have been exhausted. There is no concordant data available to support that bariatric surgery can reduce the prevalence of cancer. Using one of the largest data samples, we evaluate the correlation of bariatric surgery in morbidly obese patients with the prevalence of obesity-related cancers (breast, endometrial, esophageal, colorectal, prostate, and renal) in morbidly obese patients. Patients and methods A sample of 7,672,508 morbidly obese patients was identified from the 1994 to 2004 records of the National Inpatient Sample (NIS) database, divided into those who did and did not undergo bariatric surgery, and studied for the prevalence of obesity-associated cancers. Results Obesity was predominantly seen in the Caucasian population (68.22%). The mean age of cases who underwent bariatric surgery was younger when compared to those who did not undergo the procedure (43.89±25.16 vs. 54.90±36.40, p-value <0.0001). The highest bariatric surgery rate was seen in the Northeast (5.57%), followed by the West (4.15%), South (3.02%), and Midwest (2.96%) (p-value <0.0001). Overall, the odds of morbidly obese patients who underwent bariatric surgery and developed cancer are: esophageal cancer 0.19 (0.1218-0.3078, p <0.0001), colorectal cancer 0.0368 (0.0275- 0.0493, p <0.0001), endometrial cancer 0.0155 (0.0099-0.0244, p <0.0001), breast cancer 0.0712 (0.0582-0.0871, p <0.0001), prostate cancer 0.0285 (0.0199-0.0408, p <0.0001) and renal cancer 0.0182 (0.0106-0.0314, p <0.0001). The odds of cancer post-bariatric surgery remained significantly lower even after matching certain confounding factors. Conclusions The odds of developing breast, esophageal, prostate, renal, and colorectal cancers are significantly lower in morbidly obese patients who undergo bariatric surgery.
目的 肥胖是一种全球性流行病，给全球医疗保健带来了沉重负担。多种癌症以及因癌症导致的死亡在肥胖患者中更为普遍。在其他措施均已用尽后，减肥手术已被证明是治疗肥胖最有效的方法。目前尚无一致的数据支持减肥手术可降低癌症患病率。我们使用最大的数据样本之一，评估减肥手术在病态肥胖患者中与病态肥胖患者肥胖相关癌症（乳腺癌、子宫内膜癌、食管癌、结直肠癌、前列腺癌和肾癌）患病率之间的相关性。
患者与方法 从1994年至2004年国家住院样本（NIS）数据库记录中识别出7672508例病态肥胖患者样本，分为接受减肥手术和未接受减肥手术的两组，并研究肥胖相关癌症的患病率。
结果 肥胖在白种人人群中最为常见（68.22%）。接受减肥手术的患者平均年龄比未接受该手术的患者年轻（43.89±25.16对54.90±36.40，p值<0.0001）。减肥手术率最高的是东北部（5.57%），其次是西部（4.15%）、南部（3.02%）和中西部（2.96%）（p值<0.0001）。总体而言，接受减肥手术且患癌症的病态肥胖患者的患病几率为：食管癌0.19（0.1218 - 0.3078，p <0.0001），结直肠癌0.0368（0.0275 - 0.0493，p <0.0001），子宫内膜癌0.0155（0.0099 - 0.0244，p <0.0001），乳腺癌0.0712（0.0582 - 0.0871，p <0.0001），前列腺癌0.0285（0.0199 - 0.0408，p <0.0001）和肾癌0.0182（0.0106 - 0.0314，p <0.0001）。即使在匹配某些混杂因素后，减肥手术后患癌症的几率仍显著较低。
结论 接受减肥手术的病态肥胖患者患乳腺癌、食管癌、前列腺癌、肾癌和结直肠癌的几率显著较低。
