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Cited by 144Bariatric Surgery and OutcomesCancer Risks and FactorsEsophageal Cancer Research and Treatment

Systematic Review and Meta-Analysis of the Impact of Bariatric Surgery on Future Cancer Risk

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Wilson, Robert B., Lathigara, Dhruvi, Kaushal, Devesh·2023·International Journal of Molecular Sciences
DOI 10.3390/ijms24076192PMC PMC10094585
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Abstract

The study aimed to perform a systematic review and meta-analysis of the evidence for the prevention of future cancers following bariatric surgery. A systematic literature search of the Cochrane Library, Embase, Scopus, Web of Science and PubMed databases (2007–2023), Google Scholar and grey literature was conducted. A meta-analysis was performed using the inverse variance method and random effects model. Thirty-two studies involving patients with obesity who received bariatric surgery and control patients who were managed with conventional treatment were included. The meta-analysis suggested bariatric surgery was associated with a reduced overall incidence of cancer (RR 0.62, 95% CI 0.46–0.84, p < 0.002), obesity-related cancer (RR 0.59, 95% CI 0.39–0.90, p = 0.01) and cancer-associated mortality (RR 0.51, 95% CI 0.42–0.62, p < 0.00001). In specific cancers, bariatric surgery was associated with reduction in the future incidence of hepatocellular carcinoma (RR 0.35, 95% CI 0.22–0.55, p < 0.00001), colorectal cancer (RR 0.63, CI 0.50–0.81, p = 0.0002), pancreatic cancer (RR 0.52, 95% CI 0.29–0.93, p = 0.03) and gallbladder cancer (RR 0.41, 95% CI 0.18–0.96, p = 0.04), as well as female specific cancers, including breast cancer (RR 0.56, 95% CI 0.44–0.71, p < 0.00001), endometrial cancer (RR 0.38, 95% CI 0.26–0.55, p < 0.00001) and ovarian cancer (RR 0.45, 95% CI 0.31–0.64, p < 0.0001). There was no significant reduction in the incidence of oesophageal, gastric, thyroid, kidney, prostate cancer or multiple myeloma after bariatric surgery as compared to patients with morbid obesity who did not have bariatric surgery. Obesity-associated carcinogenesis is closely related to metabolic syndrome; visceral adipose dysfunction; aromatase activity and detrimental cytokine, adipokine and exosomal miRNA release. Bariatric surgery results in long-term weight loss in morbidly obese patients and improves metabolic syndrome. Bariatric surgery may decrease future overall cancer incidence and mortality, including the incidence of seven obesity-related cancers.

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  • Expected benefits of metabolic surgery include improved quality of life, reduced cardiovascular events, and decreased risk of hepatocellular, colorectal, pancreatic, gallbladder, breast, endometrial, and ovarian cancers.

    “In addition to weight reduction and decreased glycemia (with diabetes remission in some patients), expected benefits of metabolic surgery include improved quality of life, reduced cardiovascular events, and decreased risk of hepatocellular, colorectal, pancreatic, gallbladder, breast, endometrial, and ovarian cancers.14,123–126”

    From Diagnosis and Treatment of Type 2 Diabetes in Adults (2025) · cites this paper as [126]

    The Conclusions (page not provided) report significantly decreased incidence of all seven listed cancers after bariatric surgery. The Introduction mentions improved cardiovascular risk factors, not fewer cardiovascular events; the Discussion mentions impaired quality of life with obesity, not improved quality of life after surgery. Those two benefits are therefore not supported by this source. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • The major disadvantage of SGLT2is, GLP-1RAs, and dual GIP/GLP-1RAs, aside from their specific adverse effects, is limited access in the US due to high cost for individuals without insurance or with high-deductible health plans.

    “The major disadvantage of SGLT2is, GLP-1RAs, and dual GIP/GLP-1RAs, aside from their specific adverse effects (Table 2), is limited access in the US due to high cost for individuals without insurance or with high-deductible health plans.113”

    From Diagnosis and Treatment of Type 2 Diabetes in Adults (2025) · cites this paper as [113]

    Section 5.4 discusses weight-loss results and weight regain after GLP-1–based treatment, but not the cost or US availability of these medicines. Searches for insurance, high-deductible plans, and cost-related access found no passage addressing the claim; the access limitation mentioned in Section 5.3 concerns bariatric surgery instead. (LLM, conf=0.76)

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Cited by

Sorted by citations

Authors
Wilson, R. B., Lathigara, D., & Kaushal, D.
Affiliations
  • Liverpool Hospital (AU)
  • Camden and Campbelltown Hospitals (AU)
Corresponding author
Wilson, Robert B.
ORCID
Venue
International Journal of Molecular Sciences
Publisher
MDPI AG
Published
2023-03-24
Volume
24
Issue
7
Pages
6192
ISSN
1422-0067 (ISSN-L)
DOI
10.3390/ijms24076192
PMC
PMC10094585
OpenAlex
W4361008716
Cited by
144
References
17
Citations by year
2026: 43 · 2025: 43 · 2024: 43 · 2023: 15
FWCI
9.32
Type
journal article
Language
en
Open access
Licence
Locations
  • International Journal of Molecular Sciences (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
  • Health Sciences › Medicine › Oncology › Cancer Risks and Factors
  • Health Sciences › Medicine › Surgery › Esophageal Cancer Research and Treatment
Keywords
bariatric surgery, cancer risk, obesity, cancer prevention, obesity-related cancer, cancer mortality, hepatocellular carcinoma, colorectal cancer, pancreatic cancer, gallbladder cancer, breast cancer, endometrial cancer, ovarian cancer, cancer incidence reduction, metabolic surgery
MeSH terms
Female, Humans, Male, Neoplasms, Obesity, Morbid, Risk, Incidence, Metabolic Syndrome, Bariatric Surgery

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