Bariatric surgery may reduce the risk of pancreatic cancer in younger patients with obesity, according to a study published in the European Journal of Surgical Oncology.
Researchers found that bariatric surgery was associated with a lower risk of pancreatic cancer among patients aged 18 to 50 years but not among older patients.
For this study, researchers analyzed patients with obesity enrolled in the French national hospital discharge database. The cohort included 160,129 patients who underwent bariatric surgery and 1,263,804 who did not.
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The average follow-up was 5.2 years in the bariatric surgery group and 6.0 years in the control group. At baseline, the average body mass index (BMI) was higher in the bariatric surgery group, and this group included more women. The mean Charlson Comorbidity Index (CCI) was higher in the control group.
Overall, there was a significant reduction in the risk of pancreatic cancer for patients in the bariatric surgery group compared with the control group. The rate of pancreatic cancer per 1000 individuals per person-year of follow-up (PYFU) was 0.14 in the bariatric surgery group and 0.64 in the control group (P <.001). The crude rate of pancreatic cancer was 0.07% and 0.35%, respectively.
The reduced risk of pancreatic cancer in the bariatric surgery group persisted after the researchers adjusted for age, sex, CCI, and BMI (hazard ratio [HR], 0.567; 95% CI, 0.467-0.689; P <.0001).
In a subgroup analysis, the researchers found a significantly reduced risk of pancreatic cancer in the bariatric surgery group for patients aged 18 to 50 years but not for patients older than 50 years of age.
In the cohort aged 18 to 50 years, the rate of pancreatic cancer per 1000 individuals per PYFU was 0.04 in the bariatric surgery group and 0.15 in the control group (P <.001). The risk of pancreatic cancer remained significantly lower for the bariatric surgery group in an adjusted analysis (HR, 0.458; 95% CI, 0.296-0.708; P =.0004).
Among patients older than 50 years of age, the rate of pancreatic cancer per 1000 individuals per PYFU was 0.40 in the bariatric surgery group and 0.73 in the control group (P <.001). However, there was no significant difference in the risk of pancreatic cancer between the groups in an adjusted analysis (HR, 0.830; 95% CI, 0.671-1.029; P =.0888).
“Bariatric surgery has a protective effect against pancreatic cancer in the 18 to 50 years population,” the researchers wrote. “High-quality prospective studies are needed to confirm these results.”
Reference
Bulsei J, Chierici A, Alifano M, et al. Bariatric surgery reduces the risk of pancreatic cancer in individuals with obesity before the age of 50 years: A nationwide administrative data study in France. Eur J Surg Oncol. Published online November 8, 2022. doi:10.1016/j.ejso.2022.11.013
