Bariatric Surgery Lowers Pancreatic Cancer Risk in Obese Diabetics

Aslam Syed, MD

While many studies have examined associations between weight loss surgery and cardiovascular outcomes or glucose control, new research from an analysis of 1.4 million patients suggests bariatric surgery in obese, diabetic patients was linked to a reduction in rates of pancreatic cancer.

Presented at United European Gastroenterology (UEG) Week 2020 Virtual, results of the 20-year study indicated the prevalence of pancreatic cancer was significantly greater in patient with predisposing diabetes mellitus and no history of bariatric surgery compared to those who underwent bariatric surgery.

"Obesity and diabetes are well-known risk factors for pancreatic cancer via chronic inflammation, excess hormones and growth factors released by body fat,” said lead investigator Aslam Syed, MD, gastroenterology fellow with the Allegheny Health Network, in a statement. “Previously, bariatric surgery has been shown to improve high blood sugar levels in diabetic patients and our research shows that this surgery is a viable way in reducing the risk of pancreatic cancer in this growing, at-risk group.”

With an increasing prevalence of pancreatic cancer, investigators sought to determine whether management of risk factors could reduce the risk of developing pancreatic cancer. To do so, Syed and a team of colleagues form he Allegheny Health Network designed their study as an analysis of data from within the IBM Explorys database from 1999-2019.

For the purpose of the analysis, investigators required patients to have a clinical diagnosis of type 2 diabetes mellitus and a BMI of 35 or greater. Both Roux-en-Y gastric bypass and sleeve gastrectomy procedures were included in the analysis. Additionally, investigators used the SNOMED-CT coding system to search for patients with “malignant tumor of pancreas” to identify patients with pancreatic cancer.

From the database, investigators identified a cohort of 1,435,350 patients with concomitant diabetes mellitus and obesity. Of this group, 10,620 patients underwent subsequent bariatric surgery. Patients included in the study who underwent bariatric surgery were more likely to be female, between the ages of 18-65 years, and be Caucasian or African American (P <.05).

Upon analysis, results indicated undergoing bariatric surgery was associated with a significantly lower rate of pancreatic cancer (0.32% vs 0.19%; P=.0179).

In the aforementioned statement, Syed noted the potential benefit of bariatric surgery in obese patients and highlighted the impact this could have on a patient’s overall health.

"The average survival time at diagnosis is particularly bleak for this silent killer, at just 4.6 months, with patients losing 98% of their healthy life expectancy. Only 3% of patients survive more than five years,” added Syed. “Clinicians should consider bariatric surgery in patients with metabolic disorders, such as diabetes and obesity, to help reduce the risk and burden of pancreatic cancer.”

This study, “Bariatric Surgery Decrease Prevalence of Pancreatic Cancer in Patients with Prior Diabetes and Obesity: A 20-year National Analysis,” was presented at UEG Week 2020.