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Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial.

Artikel i vetenskaplig tidskrift
Författare Lars Sjöström
Anders Gummesson
C David Sjöström
Kristina Narbro
Markku Peltonen
Hans Wedel
Calle Bengtsson
Claude Bouchard
Björn Carlsson
Sven Dahlgren
Peter Jacobson
Kristjan Karason
Jan Karlsson
Bo Larsson
Anna-Karin Lindroos
Hans Lönroth
Ingmar Näslund
Torsten Olbers
Kaj Stenlöf
Jarl S Torgerson
Lena M S Carlsson
Publicerad i The lancet oncology
Volym 10
Nummer/häfte 7
Sidor 653-62
ISSN 1474-5488
Publiceringsår 2009
Publicerad vid Institutionen för medicin, avdelningen för samhällsmedicin och folkhälsa
Institutionen för kliniska vetenskaper, Avdelningen för anestesiologi och intensivvård
Institutionen för medicin, avdelningen för klinisk prövning och entreprenörskap
Institutionen för kliniska vetenskaper, Avdelningen för gastrokirurgisk forskning och utbildning
Institutionen för medicin, avdelningen för molekylär och klinisk medicin
Sidor 653-62
Språk en
Länkar dx.doi.org/10.1016/S1470-2045(09)70...
Ämnesord Adult, Bariatric Surgery, Case-Control Studies, Energy Intake, Female, Humans, Male, Matched-Pair Analysis, Middle Aged, Multivariate Analysis, Neoplasms, epidemiology, mortality, prevention & control, Obesity, surgery, Proportional Hazards Models, Prospective Studies, Sex Distribution, Sweden, epidemiology, Weight Loss
Ämneskategorier Endokrinologi

Sammanfattning

BACKGROUND: Obesity is a risk factor for cancer. Intentional weight loss in the obese might protect against malignancy, but evidence is limited. To our knowledge, the Swedish Obese Subjects (SOS) study is the first intervention trial in the obese population to provide prospective, controlled cancer-incidence data. METHODS: The SOS study started in 1987 and involved 2010 obese patients (body-mass index [BMI] >or=34 kg/m(2) in men, and >or=38 kg/m(2) in women) who underwent bariatric surgery and 2037 contemporaneously matched obese controls, who received conventional treatment. While the main endpoint of SOS was overall mortality, the main outcome of this exploratory report was cancer incidence until Dec 31, 2005. Cancer follow-up rate was 99.9% and the median follow-up time was 10.9 years (range 0-18.1 years). FINDINGS: Bariatric surgery resulted in a sustained mean weight reduction of 19.9 kg (SD 15.6 kg) over 10 years, whereas the mean weight change in controls was a gain of 1.3 kg (SD 13.7 kg). The number of first-time cancers after inclusion was lower in the surgery group (n=117) than in the control group (n=169; HR 0.67, 95% CI 0.53-0.85, p=0.0009). The sex-treatment interaction p value was 0.054. In women, the number of first-time cancers after inclusion was lower in the surgery group (n=79) than in the control group (n=130; HR 0.58, 0.44-0.77; p=0.0001), whereas there was no effect of surgery in men (38 in the surgery group vs 39 in the control group; HR 0.97, 0.62-1.52; p=0.90). Similar results were obtained after exclusion of all cancer cases during the first 3 years of the intervention. INTERPRETATION: Bariatric surgery was associated with reduced cancer incidence in obese women but not in obese men. FUNDING: Swedish Research Council, Swedish Foundation for Strategic Research, Swedish Federal Government under the LUA/ALF agreement, Hoffmann La Roche, Cederoths, AstraZeneca, Sanofi-Aventis, Ethicon Endosurgery.

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