Evidence map›Paper›PMID 28938270›Full record

Observational studyAnnals of surgery2019

Bariatric Surgery and the Risk of Cancer in a Large Multisite Cohort.

Daniel P Schauer, Heather Spencer Feigelson, Corinna Koebnick, Bette Caan, Sheila Weinmann, Anthony C Leonard, J David Powers, Panduranga R Yenumula, David E Arterburn

2 registry-linked trialsAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Annals of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 148 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
148citing papers in PubMed, 16 pooled it
23.3field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06132477 phase4recruitingstarted 2024, after this paper: background citation

Biometabolic Impact of Continuation of GLP-1 Agonists Following Bariatric

Ran2024Enrolled150Registered outcomes5Posted comparisons0ConditionsDiabetes Mellitus, Hypertension, Metabolic Syndrome, Morbid ObesityArmsGLP-1 receptor agonist
PMID 28266779PMID 36765019PMID 32656729PMID 21844879PMID 35317659PMID 35105664PMID 34920733PMID 34822391PMID 34084153PMID 34016530PMID 33518159PMID 33434516other papers from this trial
Open the trial in the graph
NCT04170335 withdrawnnot on this mapstarted 2021, after this paper: background citation

Effects of Bariatric Surgery on Breast Density Improvement and Its Impact on Breast Cancer Risk in Morbidly Obese Patients

TypeobservationalSponsorThe Cleveland ClinicRan2021 to 2023Enrolled0ConditionsBreast Cancer, Morbid Obesity, Bariatric Surgery CandidateArmsBariatric surgery
3 · Its place in the literature

Who cites it

148 citing papers in PubMed, 16 syntheses or guidelines pooled it, 365 citations in OpenAlex.

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  13. Changes in Time of Gastric Emptying After Surgical and Endoscopic Bariatrics and Weight Loss: A Systematic Review and Meta-Analysis.Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2020
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  14. Intentional weight loss, weight cycling, and endometrial cancer risk: a systematic review and meta-analysis.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2019
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88 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 4 institutions in 1 country.

Daniel P SchauerDivision of General Internal Medicine and Center for Clinical Effectiveness, University of Cincinnati, Cincinnati, OH.
Heather Spencer FeigelsonKaiser Permanente Colorado, Denver, CO.
Corinna KoebnickKaiser Permanente Southern California, Pasadena, CA.
Bette CaanKaiser Permanente Northern California, Oakland, CA.
Sheila WeinmannKaiser Permanente Northwest, Portland, OR.
Anthony C LeonardDepartment of Family and Community Medicine, University of Cincinnati Medical Center, Cincinnati, OH.
J David PowersKaiser Permanente Colorado, Denver, CO.
Panduranga R YenumulaKaiser Permanente Northern California, Oakland, CA.
David E ArterburnKaiser Permanente Washington Health Research Institute, Seattle, WA.
Kaiser Permanente · USKaiser Permanente Washington Health Research Institute · USUniversity of Cincinnati · USUniversity of Cincinnati Medical Center · US

Funding

NCI NIH HHS R01 CA175346
6 · The paper itself

Abstract

objectiveTo determine whether bariatric surgery is associated with a lower risk of cancer.

backgroundObesity is strongly associated with many types of cancer. Few studies have examined the relationship between bariatric surgery and cancer risk.

methodsWe conducted a retrospective cohort study of patients undergoing bariatric surgery between 2005 and 2012 with follow-up through 2014 using data from a large integrated health insurance and care delivery systems with 5 study sites. The study included 22,198 subjects who had bariatric surgery and 66,427 nonsurgical subjects matched on sex, age, study site, body mass index, and Elixhauser comorbidity index. Multivariable Cox proportional-hazards models were used to examine incident cancer up to 10 years after bariatric surgery compared to the matched nonsurgical patients.

resultsAfter a mean follow-up of 3.5 years, we identified 2543 incident cancers. Patients undergoing bariatric surgery had a 33% lower hazard of developing any cancer during follow-up [hazard ratio (HR) 0.67, 95% confidence interval (CI) 0.60, 0.74, P < 0.001) compared with matched patients with severe obesity who did not undergo bariatric surgery, and results were even stronger when the outcome was restricted to obesity-associated cancers (HR 0.59, 95% CI 0.51, 0.69, P < 0.001). Among the obesity-associated cancers, the risk of postmenopausal breast cancer (HR 0.58, 95% CI 0.44, 0.77, P < 0.001), colon cancer (HR 0.59, 95% CI 0.36, 0.97, P = 0.04), endometrial cancer (HR 0.50, 95% CI 0.37, 0.67, P < 0.001), and pancreatic cancer (HR 0.46, 95% CI 0.22, 0.97, P = 0.04) was each statistically significantly lower among those who had undergone bariatric surgery compared with matched nonsurgical patients.

conclusionsIn this large, multisite cohort of patients with severe obesity, bariatric surgery was associated with a lower risk of incident cancer, particularly obesity-associated cancers, such as postmenopausal breast cancer, endometrial cancer, and colon cancer. More research is needed to clarify the specific mechanisms through which bariatric surgery lowers cancer risk.

Indexed as

AdolescentAdultAgedBariatric SurgeryBody Mass IndexFemaleFollow-Up StudiesHumansIncidenceMaleMiddle AgedNeoplasmsObesity, MorbidPrognosisRetrospective StudiesTime Factors

Identifiers

PMID28938270
PMCPMC6201282
OpenAlexW2760432946

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.