ImportanceCancer is one of the leading causes of death in the United States, with the obesity epidemic contributing to its steady increase every year. Recent cohort studies find an association between bariatric surgery and reduced longitudinal cancer risk, but with heterogeneous findings.ObservationsThis review summarizes how obesity leads to an increased risk of developing cancer and synthesizes current evidence behind the potential for bariatric surgery to reduce longitudinal cancer risk. Overall, bariatric surgery appears to have the strongest and most consistent association with decreased incidence of developing breast, ovarian, and endometrial cancers. The association of bariatric surgery and the development of esophageal, gastric, liver, and pancreas cancer is heterogenous with studies showing either no association or decreased longitudinal incidences. Conversely, there have been preclinical and cohort studies implying an increased risk of developing colon and rectal cancer after bariatric surgery. A review and synthesis of the existing literature reveals epidemiologic shortcomings of cohort studies that potentially explain incongruencies observed between studies.Conclusions and RelevanceStudies examining the association of bariatric surgery and longitudinal cancer risk remain heterogeneous and could be explained by certain epidemiologic considerations. This review provides a framework to better define subgroups of patients at higher risk of developing cancer who would potentially benefit more from bariatric surgery, as well as subgroups where more caution should be exercised.

中文翻译：

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减肥手术和纵向癌症风险

重要性癌症是美国主要的死亡原因之一，而肥胖的流行导致其每年稳步增加。最近的队列研究发现减肥手术与降低纵向癌症风险之间存在关联，但结果存在异质性。 观察这篇综述总结了肥胖如何导致患癌症风险增加，并综合了减肥手术降低纵向癌症风险潜力的当前证据。总体而言，减肥手术似乎与降低乳腺癌、卵巢癌和子宫内膜癌的发病率具有最强且最一致的关联。减肥手术与食管癌、胃癌、肝癌和胰腺癌的发生之间的关联是异质的，研究显示要么没有关联，要么纵向发病率降低。相反，临床前和队列研究表明减肥手术后患结肠癌和直肠癌的风险增加。对现有文献的回顾和综合揭示了队列研究的流行病学缺陷，这些缺陷可能解释研究之间观察到的不一致。结论和相关性检查减肥手术与纵向癌症风险之间关系的研究仍然存在异质性，并且可以通过某些流行病学考虑因素来解释。该综述提供了一个框架，以更好地定义罹患癌症风险较高的患者亚组（这些患者可能从减肥手术中获益更多），以及应更加谨慎的亚组。