Bariatric Surgery May Reduce Risk of Uterine Cancer

Dr. Kristy Ward Department of Reproductive Medicine UCSD School of MedicineMedicalResearch.com Interview with:
Dr. Kristy Ward
Department of Reproductive Medicine
UCSD School of Medicine

 

MedicalResearch.com: What are the main findings of this study?

Dr. Ward: As the second leading cause of preventable death, obesity is one of the nation’s most serious public health problems.  Over two-thirds of the US population is currently overweight or obese and the prevalence continues to increase.  A number of studies have linked obesity with an overall elevated risk of cancer and with many individual cancer types. Among obesity related cancers in women, endometrial cancer is most strongly associated with increasing body mass, with 39% of cases in the US attributable to obesity.

In patients with clinically severe obesity (BMI ≥ 40 kg/m2), bariatric surgery results in rapid weight loss and has greater long-term success when compared to non-surgical weight loss methods. Surgical weight loss procedures have been found to reduce obesity-related comorbidites and improve outcomes in clinically severe obese populations. In addition to improved cardiovascular risk factors and mitigation of physical symptoms, there is increasing evidence that cancer risk is reduced after bariatric surgery.

The current study looks at data recorded in the University Health System Consortium (UHC) database to estimate the potential impact of bariatric surgery on the risk of uterine malignancy.  The UHC maintains an administrative database with information representing over 90% of US nonprofit academic medical centers.

A total of 7,431,858 admissions of women were recorded during the study period.  Out of the total, 103,797 had a history of bariatric surgery and 44,345 had a diagnosis of uterine malignancy. Overall, women who were not currently obese had a lower risk of uterine malignancy than women who were currently obese.

We estimate that a 71% reduction in risk of uterine malignancy is associated with having bariatric surgery; with a maximal risk reduction of 81% if a normal weight is maintained after surgery, and a 52% reduction if normal BMI is not achieved or maintained.

A history of bariatric surgery is associated with a substantial and clinically significant reduced risk for uterine malignancy.  Our previous work, in agreement with the findings of others, has indicated that the risk of uterine malignancy increases linearly with BMI. Along with the findings of this current study, this supports that obesity may be a modifiable risk factor related to development of endometrial cancer.

Weight reduction measures, which may include bariatric surgery in appropriate candidates, are vitally important in obese women.  Screening for and counseling patients about the dangers of obesity and appropriate referral for bariatric surgery may have a great impact in the overall health of this population.  Our findings suggest a potential role for bariatric surgery in endometrial cancer prevention. Future research should be undertaken to further examine the benefits of bariatric surgery for the reduction of cancer risk including endometrial cancer.

Citation:

Bariatric surgery decreases the risk of uterine malignancy
Gynecologic Oncology, Volume 133, Issue 1, April 2014, Pages 63-66
Kristy K. Ward, Angelica M. Roncancio, Nina R. Shah, Mitzie-Ann Davis, Cheryl C. Saenz, Michael T. McHale, Steven C. Plaxe