Pancreatic cancer is one of the most feared malignancies due to its typically late diagnosis and poor survival rates. As one of the leading causes of cancer-related death worldwide, it demands all possible measures of prevention. One newly recognized potential avenue for reducing the risk of pancreatic cancer is metabolic-bariatric surgery (MBS). A recent study has shed light on the significant reduction in pancreatic cancer risk following MBS in individuals with obesity, irrespective of their Type 2 diabetes (T2D) status. Here, we break down the key findings and their implications for the general population.
Obesity, Type 2 Diabetes, and Pancreatic Cancer: A Dangerous Trio
Obesity has become a major public health concern, with its prevalence tripling since 1975. It is now estimated that by 2030, 1 billion people globally will be classified as obese. Obesity is not just a cosmetic issue—it is a leading risk factor for life-threatening conditions, including cardiovascular diseases, diabetes, and certain cancers. One particularly deadly cancer linked to obesity is pancreatic cancer.
Research indicates that for every 5-unit increase in body mass index (BMI), the risk of pancreatic cancer rises by 10%. Similarly, Type 2 diabetes—a condition often linked with obesity—also heightens the risk. This makes prevention and early management of obesity essential in lowering the risk of developing pancreatic cancer.
How Bariatric Surgery Can Help
Metabolic-bariatric surgery (MBS) has long been recognized as an effective tool for achieving significant and sustained weight loss in individuals with obesity. More than that, MBS also dramatically improves or even resolves conditions like Type 2 diabetes. Studies have also shown its ability to reduce the incidence of obesity-related cancers, such as colorectal, breast, and endometrial cancers.
The latest meta-analysis, involving over 3.7 million adults, takes this a step further by analyzing the impact of MBS on pancreatic cancer risk specifically. It highlights that MBS reduces the risk of pancreatic cancer in both diabetic and non-diabetic populations with obesity. The risk reduction was found to be more pronounced in those with both obesity and Type 2 diabetes, with a relative risk reduction of up to 79%.
Key Findings from the Study
This meta-analysis, conducted by Angelidi et al. and published in Diabetes/Metabolism Research and Reviews in 2024, synthesized data from 12 studies and over 3.7 million participants. The results revealed:
- A 54% reduction in pancreatic cancer risk among patients who underwent MBS compared to those who did not, regardless of their Type 2 diabetes status.
- In patients with obesity but without diabetes, MBS was associated with a 44% reduction in pancreatic cancer risk.
- In individuals with both obesity and Type 2 diabetes, the risk reduction reached 79%.
These findings suggest that MBS can significantly lower the risk of pancreatic cancer across a wide range of individuals struggling with obesity. Furthermore, this study shows that the impact of MBS may be even more significant in people with diabetes, a population already at increased risk of this aggressive cancer.
Why Does Bariatric Surgery Help?
While the exact mechanisms behind MBS’s protective effect on pancreatic cancer remain unclear, several plausible explanations exist. Bariatric surgery leads to significant and sustained weight loss, which directly addresses the primary risk factor: obesity. Additionally, MBS has been shown to result in remission of Type 2 diabetes in many cases, reducing the chronic high insulin levels that are linked with pancreatic cell overgrowth and cancer development.
Other potential mechanisms include improvements in insulin sensitivity, reductions in inflammation, and normalization of hormones such as leptin and adiponectin, which play roles in cancer development. Bariatric surgery may also alter molecular pathways, such as those involving insulin growth factor (IGF) and the mTOR pathway, both of which are implicated in cancer cell growth.
Sleeve Gastrectomy vs. Gastric Bypass: Is One Surgery Better?
Another intriguing aspect of this meta-analysis was the comparison between the types of MBS procedures. The study found that sleeve gastrectomy (SG) showed a more pronounced reduction in pancreatic cancer risk compared to Roux-en-Y gastric bypass (RYGB), although both procedures were beneficial.
SG reduced the risk of pancreatic cancer by 76%, compared to a 48% reduction in the RYGB group. While further studies are needed to understand why SG may have a stronger effect, this finding is encouraging for patients and physicians considering different types of bariatric surgery.
The Bigger Picture: Beyond Pancreatic Cancer
The protective effect of MBS isn’t limited to pancreatic cancer alone. Numerous studies have confirmed that weight loss surgery reduces the risk of various cancers, particularly those closely linked to obesity and metabolic dysfunction. For example, women who undergo MBS have a lower risk of breast and endometrial cancer, while both men and women see reductions in their risk for colorectal and liver cancers. In my write up, The Weighty Connection: Exploring the Association Between Obesity and Cancer, you can learn more about Obesity and Cancer.
This meta-analysis supports the growing body of evidence that MBS offers far more than weight loss—it’s a critical tool in reducing cancer risk and improving long-term health outcomes for individuals with obesity.
Conclusion: Bariatric Surgery as Cancer Prevention
With obesity rates continuing to rise globally, the role of MBS in cancer prevention is becoming increasingly important. This study highlights that bariatric surgery is a powerful intervention not just for weight loss and diabetes remission but also for reducing the risk of pancreatic cancer—a deadly and difficult-to-treat malignancy.
While more research is needed to fully understand the mechanisms behind this risk reduction and to refine surgical approaches, this meta-analysis provides strong evidence in support of MBS as a valuable preventive measure against pancreatic cancer.
Dive deeper into the world of obesity and its treatment strategies by exploring the insights shared in my latest book, “Losing Weight Gaining Life: A Complete Guide to Overcoming Obesity.” This comprehensive resource offers invaluable information to empower you on your journey towards a healthier life.
References
Angelidi, A.M., Martinou, E.G., Karamanis, D.G. (2024). Metabolic Bariatric Surgery Reduces Pancreatic Cancer Risk: A Meta-Analysis of Over 3.7 Million Adults, Independent of Type 2 Diabetes Status. Diabetes/Metabolism Research and Reviews.
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