Metabolic and bariatric surgery reduces the risk of hematological cancer in individuals with obesity: a nationwide administrative data study in France

代谢和减肥手术可降低肥胖患者罹患血液系统癌症的风险:一项法国全国性行政数据研究

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Abstract

OBJECTIVES: This study aimed to assess the association between Metabolic and Bariatric Surgery (MBS) and the risk of developing hematological cancers in individuals with obesity. SUMMARY BACKGROUND DATA: Epidemiological evidence indicates that MBS is associated with a reduction in the risk of solid cancers in individuals with obesity while its effect against the risk of hematological cancer is less clear. METHODS: We conducted a cohort study comparing the risk to develop hematological cancer in individuals with a principal diagnosis of obesity with and without history of MBS that were extracted from the French national hospital discharge database. The protective effect of MBS on the risk of hematological cancer was studied in the overall population and in subgroup analyses according to gender and type of surgical procedure (sleeve gastrectomy vs Roux-en-Y gastric bypass). RESULTS: The main analysis showed a significant reduction in the risk of Hodgkin lymphoma (0.511 [0.332-0.787]), non-Hodgkin lymphomas (0.467 [0.369-0.591]), leukemia (0.563 [0.452-0.702]) and multiple myeloma (0.389 [0.268-0.566]) in the MBS group after adjusting for age, sex, obesity severity and risk factors for hematological cancer. The propensity score analysis (139 414 individuals in the MBS group versus 278 828 in the control group) confirmed these results. The protective effect of MBS was consistent across genders and type of surgery. CONCLUSION: MBS is associated with a significant reduction in the risk of hematological cancer in men and women and sleeve gastrectomy and Roux-en-Y gastric bypass are equally effective.

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