Weight loss surgery in obese diabetic patients significantly cuts pancreatic cancer risk

Weight loss surgery significantly cuts the risk of developing pancreatic cancer in people who are obese with diabetes, a new 20-year analysis has found.

The study, presented today at UEG Week 2020 Virtual, analyzed 1,435,350 patients with concurrent diabetes and obesity over a 20-year period. A total of 10,620 patients within the study had undergone bariatric (weight loss) surgery, an operation that helps patients lose weight by making changes to the digestive system.

The research found that obese patients with diabetes were significantly less likely to develop pancreatic cancer if they had undergone bariatric surgery (prevalence of 0.32% vs 0.19%, p<0.05). The majority of patients (73%) that underwent surgery within the study were female.

Lead author Dr. Aslam Syed from the Allegheny Health Network, Division of Gastroenterology in Pittsburgh, U.S., said, "Obesity and diabetes are well-known risk factors for pancreatic cancer via chronic inflammation, excess hormones and growth factors released by body fat. Previously, bariatric surgery has been shown to improve high blood sugar levels in diabetic patients and our research shows that this surgery is a viable way in reducing the risk of pancreatic cancer in this growing, at-risk group."

The findings are particularly timely, with rates of diabetes, obesity and pancreatic cancer all on the rise.

For pancreatic cancer, cases in the EU increased by 5% between 1990 and 2016—the highest increase in the EU's top five cancers—with the disease expected to be the second leading cause of cancer death in the near future. A total of 46,200 people are estimated to die from the disease in Europe in 2020, compared to 42,200 deaths recorded in 2015. The increase in cases is believed to be fuelled by rising rates of obesity and type 2 diabetes.

Obesity rates continue to increase at a rapid and concerning pace across Europe, with little expectation that these figures will decrease or plateau. Over half (52%) of the adult EU population is either overweight or obese, with growing rates also prevalent in children.

Dr. Syed explains how preventing pancreatic cancer is crucial, with a lack of improvements in the survival of the disease for four decades. "The average survival time at diagnosis is particularly bleak for this silent killer, at just 4.6 months, with patients losing 98% of their healthy life expectancy. Only 3% of patients survive more than five years."

Often referred to as the "silent killer," symptoms of pancreatic cancer—which include pain in the back or stomach, jaundice and unexplained weight loss—can be hard to identify which adds difficulties in diagnosing patients early.

"Clinicians should consider bariatric surgery in patients with metabolic disorders, such as diabetes and obesity, to help reduce the risk and burden of pancreatic cancer," adds Dr. Syed.