IS WEIGHT-LOSS SURGERY THE NEXT WAVE IN
CANCER
PREVENTION?
Newly published data suggest that weight-loss
surgery can prevent cancer. After 20 years, the
landmark Swedish Obesity Study (SOS) has
provided research showing that weight-loss surgery is
associated with a reduction in the incidence of primary
cancer diagnoses. This reduction is shown especially
in female-specific cancers, predominantly endometrial
cancer. The findings of this study have revolutionised
ongoing research into weight-loss surgery.
This year, an estimated 134,000 Australians will be
diagnosed with cancer. The relationship between obesity
and cancer is, therefore, a vital one. In 2014, 63.4 percent
of Australians were overweight — well over half the
population. The new data from the Swedish Obesity Study
suggests that the incidence of certain cancers in people
with obesity can be reduced by weight-loss surgery.
The Swedish Obesity Study looked specifically at the
long-term effects of bariatric surgery on female-specific
cancers in women with obesity. A cohort of 1420 women
underwent bariatric surgery, while 1447 matched controls
received conventional obesity treatment (controlled diet
and exercise).
Primarily, the study confirms that conventional
treatments for obesity (diet and exercise) are less effective
than weight-loss surgery in achieving significant, sustained
weight-loss. The patients in the study who underwent
conventional weight-loss programs experienced an initial
dip in median weight, before spending the following
decade heavier than they were before the study.
The cohort who undertook bariatric surgery experienced
faster weight-loss, which they were able to sustain long-term.
The data suggests that surgical weight-loss is the best
option for significant, rapid, and prolonged weight-loss.
The study demonstrates what was previously only
suggested in retrospective studies and meta-analysis —
that weight-loss surgery is associated with a reduction in
primary cancer diagnoses. It shows that this is especially
true in female-specific cancers, notably endometrial
cancer. Weight-loss surgery is also potentially associated
with a reduction in all medical causes of death. Weight-loss
surgery is linked with reduced rates of multiple health
risks including diabetes, stroke, heart attacks, heart rhythm
disorders, gout and overall mortality.
It is possible that surgery for weight-loss may be less
effective in some individual cases or have more upfront
or overall costs. However, it may also provide more long-term
benefit and cost savings by treating the root cause of
multiple health problems. Going forward, deciding on the
best methods of cancer prevention will require continued
investment into the biology, psychology, and epidemiology
of weight gain and weight-loss.
The Swedish Obesity Study will have ongoing and
significant implications for the investigation of surgical
weight-loss in relation to cancer risk reduction. It has shed
light on the direct connection between weight-loss surgery
and reduced incidence of cancer diagnosis, especially in
female-specific cancers. This new information will inform
cancer studies and treatment into the future.
Dr Jorrie Jordaan | Bariatric Surgeon
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