Skin cancer reductions seen with bariatric surgery

  • Taube M & al.
  • JAMA Dermatol
  • 30 Oct 2019

  • International Clinical Digest
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Takeaway

  • Patients with obesity who have bariatric surgery have a reduced risk for skin cancer, including melanoma.
  • The findings of this trial suggest some association of obesity with skin cancer.

Why this matters

  • Obesity is a known general risk factor for some cancers, but its associations with skin cancer, especially melanoma, are not established.

Key results

  • Median follow-up was 18.1 years.
  • Melanoma risk was reduced after bariatric surgery: adjusted subhazard ratio, 0.43 (95% CI, 0.21-0.87; P=.02).
    • Incidence rates were 0.8 (95% CI, 0.6-1.2) per 1000 person-years without surgery vs 0.3 (95% CI, 0.2-0.6) per 1000 person-years with surgery.
  • General skin cancer risk also decreased after the surgery: adjusted subhazard ratio, 0.59 (95% CI, 0.35-0.99; P=.047).
    • Incidence rates for general skin cancer were 1.2 (95% CI, 0.9-1.6) per 1000 person-years without surgery vs 0.7 (95% CI, 0.4-1.0) per 1000 person-years with surgery.
  • No association was found with baseline BMI, body weight, metabolic measures, BP, alcohol intake, or smoking.

Study design

  • Nonrandomized controlled trial, Sweden, 25 surgery departments, 480 primary health care centers.
  • Cancer event data for 4042 patients were analyzed.
  • Funding: National Institute of Diabetes and Digestive and Kidney Diseases; Swedish government and foundations.

Limitations

  • Skin cancer incidence was not a predefined endpoint.