Bariatric Surgery Lowers Risk for Uterine Cancer
March 24, 2014
Obese women could reduce their risk of developing uterine cancer by as much as 70% with bariatric surgery, according to new research.
And if the women maintain a normal weight after surgery, this dramatic decrease in risk is even better — up to 81%, said lead investigator Kristy Ward, MD, from the University of California, San Diego.
She presented the findings at the Society of Gynecologic Oncology 45th Annual Meeting on Women's Cancer in Tampa, Florida.
We know that endometrial cancer is strongly associated with obesity," Dr. Ward told Medscape Medical News in a telephone interview.
In fact, "it has been estimated that as much as 37% of uterine cancer is associated with obesity," she reported. Of all the obesity-related cancers, uterine cancer has the strongest association with obesity.
"Uterine cancer is also the most common cancer of the female reproductive organs, affecting about 50,000 women in 2013. Endometrial cancer, which occurs in the inner lining of the uterus, accounts for 95% of those cancers," Dr. Ward said.
She and her group decided to see if bariatric surgery, with its resulting weight loss, decreases the risk for either uterine or endometrial cancer.
They used one of the largest healthcare databases in the United States — the University HealthSystem Consortium dataset — to analyze 7,431,858 women 18 years and older who were admitted to the hospital from January 2009 and June 2013.
Of the 103,797 women who had undergone bariatric surgery, 424 (0.4%) had a diagnosis of uterine malignancy. Of the 832,372 women considered obese who had not undergone bariatric surgery, 11,729 (1.4%) had that diagnosis.
"In other words, obese women who had bariatric surgery were 3 and a half times less likely to get uterine cancer than women who had not had the surgery," Dr. Ward said.
For nonobese women who had never undergone bariatric surgery, 32,192 of the nearly 6.5 million admitted to the hospital (0.5%) were diagnosed with uterine cancer.
A Significant Finding
Anything that lowers the incidence of severe obesity is going to significantly decrease the risk for endometrial cancer, said Thomas Herzog, MD, division director of genitourinary oncology at Columbia University in New York City.
"Bariatric surgery is yet another prevention strategy that one could consider for someone who is massively obese and who has failed to lose weight through diet and exercise," he noted.
However, Dr. Herzog, who was not involved with the study, cautioned that bariatric surgery is not without its risks.
"Most of these procedures go well, but there are reports of some patients who have lifelong problems after bariatric surgery, so that caveat has to be mentioned," he explained.
"In this study, the success of bariatric surgery is not clearly described. Some people have great success at losing weight; some have had success but then have malnutrition. When you look at large population databases such as this, you don't get the level of detail that you would like. Nonetheless, I think it's a significant finding," he told Medscape Medical News.
Dr. Ward and Dr. Herzog have disclosed no relevant financial relationships.
Society of Gynecologic Oncology (SGO) 45th Annual Meeting on Women's Cancer: Abstract 4. Presented March 22, 2014.