Abstract
Obesity is associated with an increased risk of at least 13 different cancers, as
well as worse cancer outcomes and increased cancer mortality. As rates continue to
rise both in the United States and worldwide, obesity is poised to become the leading
lifestyle-related risk factor for cancer. Currently, the most effective treatment
for patients with severe obesity is bariatric surgery. Multiple cohort studies have
demonstrated a consistent >30% decreased risk of cancer incidence in women, but not
men, following bariatric surgery. However, the physiologic mechanisms driving obesity-associated
cancer and the cancer-protective effect of bariatric surgery are not clearly defined.
In this review, we highlight emerging concepts in the mechanistic understanding of
obesity-associated cancer. Evidence from both human studies and preclinical animal
models suggest that obesity drives carcinogenesis through dysregulation of systemic
metabolism, immune dysfunction, and an altered gut microbiome. Additionally, we present
related findings to suggest that bariatric surgery may disrupt and even reverse many
of these mechanisms. Finally, we discuss the use of preclinical bariatric surgery
animal models in the study of cancer biology. The prevention of cancer is emerging
as an important indication for bariatric surgery. Elucidating the mechanisms through
which bariatric surgery limits carcinogenesis is critical to developing a variety
of interventions that intercept obesity-driven cancer.
Keywords
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Article info
Publication history
Published online: February 28, 2023
Publication stage
In Press Journal Pre-ProofIdentification
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© 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
