Background/Objectives: Metabolic and bariatric surgery (MBS) is known to reduce cancer risk. However, the association between specific bariatric procedures and cancer incidence is not well-studied. This study examined the association between four different MBS procedures and cancer incidence.Methods: Bariatric surgery registry data were linked with statewide cancer registry data from 1979 to 2018. The study included 27,092 adult subjects (aged ≥ 18 years old at surgery) who underwent MBS (BMI ≥ 30 kg/m2at surgery) from 1979 to 2017. Cancer records were linked to MBS patient records, resulting in 1547 cancer cases. Cox proportional hazards regression was used to examine the association between MBS procedure types and cancer incidence.Results: Of all patients, 75% underwent Roux-en-Y gastric bypass (RYGB), 9% adjustable gastric banding (AGB), 10% sleeve gastrectomy (SG), and 6% duodenal switch (BPD-DS). The overall cancer incidence during the follow-up period was 6.4% for RYGB, 4.6% for AGB, 1.6% for SG, and 5.9% for BPD-DS. The mean follow-up duration from surgery to cancer incidence or censoring was 167 months (standard deviation = 121 months). Compared to RYGB, patients who underwent AGB (Hazard Ratio [HR] = 1.26,p= 0.03) and BPD-DS (HR = 1.91,p< 0.01) had a significantly higher hazard of developing cancer, while SG (HR = 1.17,p= 0.33) showed no significant difference.Conclusions: These findings suggest that AGB and BPD-DS may be associated with higher cancer risks compared to RYGB. Additional large population studies are needed to better understand the long-term cancer risks and mechanisms associated with different MBS types.
背景/目的：代谢与减重手术（MBS）已知可降低癌症风险。然而，特定减重手术方式与癌症发病率之间的关联尚未得到充分研究。本研究探讨了四种不同MBS术式与癌症发病率之间的关系。 方法：将1979年至2018年间的减重手术登记数据与全州癌症登记数据进行关联。研究纳入了1979年至2017年间接受MBS的27,092名成年受试者（手术时年龄≥18岁，体重指数≥30 kg/m²）。通过将癌症记录与MBS患者记录进行匹配，共识别出1547例癌症病例。采用Cox比例风险回归模型分析MBS术式类型与癌症发病率之间的关联。 结果：在所有患者中，75%接受了Roux-en-Y胃旁路术（RYGB），9%接受了可调节胃束带术（AGB），10%接受了袖状胃切除术（SG），6%接受了十二指肠转位术（BPD-DS）。随访期间总体癌症发病率分别为：RYGB组6.4%、AGB组4.6%、SG组1.6%、BPD-DS组5.9%。从手术到癌症发生或数据截尾的平均随访时间为167个月（标准差=121个月）。与RYGB相比，接受AGB（风险比[HR]=1.26，p=0.03）和BPD-DS（HR=1.91，p<0.01）的患者发生癌症的风险显著更高，而SG（HR=1.17，p=0.33）则无显著差异。 结论：这些研究结果表明，与RYGB相比，AGB和BPD-DS可能与更高的癌症风险相关。需要进一步开展大规模人群研究，以更好地理解不同MBS术式相关的长期癌症风险及其机制。
Long-Term Cancer Outcomes Following Bariatric Surgery: A Comparative Analysis of Surgical Procedures
肿瘤(癌症)患者之家