{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T12:57:07Z","timestamp":1792069027180,"version":"4.4.0"},"reference-count":129,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2023,3,24]],"date-time":"2023-03-24T00:00:00Z","timestamp":1679616000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The study aimed to perform a systematic review and meta-analysis of the evidence for the prevention of future cancers following bariatric surgery. A systematic literature search of the Cochrane Library, Embase, Scopus, Web of Science and PubMed databases (2007\u20132023), Google Scholar and grey literature was conducted. A meta-analysis was performed using the inverse variance method and random effects model. Thirty-two studies involving patients with obesity who received bariatric surgery and control patients who were managed with conventional treatment were included. The meta-analysis suggested bariatric surgery was associated with a reduced overall incidence of cancer (RR 0.62, 95% CI 0.46\u20130.84, p &lt; 0.002), obesity-related cancer (RR 0.59, 95% CI 0.39\u20130.90, p = 0.01) and cancer-associated mortality (RR 0.51, 95% CI 0.42\u20130.62, p &lt; 0.00001). In specific cancers, bariatric surgery was associated with reduction in the future incidence of hepatocellular carcinoma (RR 0.35, 95% CI 0.22\u20130.55, p &lt; 0.00001), colorectal cancer (RR 0.63, CI 0.50\u20130.81, p = 0.0002), pancreatic cancer (RR 0.52, 95% CI 0.29\u20130.93, p = 0.03) and gallbladder cancer (RR 0.41, 95% CI 0.18\u20130.96, p = 0.04), as well as female specific cancers, including breast cancer (RR 0.56, 95% CI 0.44\u20130.71, p &lt; 0.00001), endometrial cancer (RR 0.38, 95% CI 0.26\u20130.55, p &lt; 0.00001) and ovarian cancer (RR 0.45, 95% CI 0.31\u20130.64, p &lt; 0.0001). There was no significant reduction in the incidence of oesophageal, gastric, thyroid, kidney, prostate cancer or multiple myeloma after bariatric surgery as compared to patients with morbid obesity who did not have bariatric surgery. Obesity-associated carcinogenesis is closely related to metabolic syndrome; visceral adipose dysfunction; aromatase activity and detrimental cytokine, adipokine and exosomal miRNA release. Bariatric surgery results in long-term weight loss in morbidly obese patients and improves metabolic syndrome. Bariatric surgery may decrease future overall cancer incidence and mortality, including the incidence of seven obesity-related cancers.<\/jats:p>","DOI":"10.3390\/ijms24076192","type":"journal-article","created":{"date-parts":[[2023,3,27]],"date-time":"2023-03-27T03:31:48Z","timestamp":1679887908000},"page":"6192","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":140,"title":["Systematic Review and Meta-Analysis of the Impact of Bariatric Surgery on Future Cancer Risk"],"prefix":"10.3390","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7408-4695","authenticated-orcid":false,"given":"Robert B.","family":"Wilson","sequence":"first","affiliation":[{"name":"Department of Upper Gastrointestinal Surgery, University of New South Wales, Liverpool Hospital, Liverpool, NSW 2170, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhruvi","family":"Lathigara","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University of Western Sydney, Campbelltown Hospital, Campbelltown, NSW 2560, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Devesh","family":"Kaushal","sequence":"additional","affiliation":[{"name":"Department of General Surgery, University of Western Sydney, Campbelltown Hospital, Campbelltown, NSW 2560, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,24]]},"reference":[{"key":"ref_1","unstructured":"Australian Institute of Health and Welfare (2022, November 29). Cancer data in Australia [Internet], Available online: https:\/\/www.aihw.gov.au\/reports\/cancer\/cancer-data-in-australia\/data."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer Statistics 2020: GLO-BOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J. Clin."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"88","DOI":"10.3322\/caac.21499","article-title":"Global patterns in excess body weight and the associated cancer burden","volume":"69","author":"Sung","year":"2018","journal-title":"CA Cancer J. Clin."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1002\/ijc.31088","article-title":"How many cancer cases and deaths are potentially preventable? Estimates for Australia in 2013","volume":"142","author":"Wilson","year":"2017","journal-title":"Int. J. Cancer"},{"key":"ref_5","unstructured":"Australian Institute of Health and Welfare (2022, November 29). Overweight and obesity [Internet]. Canberra: Australian Institute of Health and Welfare, Available online: https:\/\/www.aihw.gov.au\/reports\/australias-health\/overweight-and-obesity."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1016\/S0140-6736(14)60892-8","article-title":"Body-mass index and risk of 22 specific cancers: A population-based cohort study of 5.24 million UK adults","volume":"384","author":"Bhaskaran","year":"2014","journal-title":"Lancet"},{"key":"ref_7","first-page":"71","article-title":"Obesity and Cancer Risk: Recent Review and Evidence","volume":"13","author":"Chang","year":"2010","journal-title":"Curr. Oncol. Rep."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1056\/NEJMsr1606602","article-title":"Body Fatness and Cancer\u2014Viewpoint of the IARC Working Group","volume":"375","author":"Scoccianti","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"100575","DOI":"10.1016\/j.lanwpc.2022.100575","article-title":"An ecological study of obesity-related cancer incidence trends in Australia from 1983 to 2017","volume":"29","author":"Feletto","year":"2022","journal-title":"Lancet Reg. Health West. Pac."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1052","DOI":"10.15585\/mmwr.mm6639e1","article-title":"Vital Signs: Trends in Incidence of Cancers Associated with Overweight and Obesity\u2014United States, 2005\u20132014","volume":"66","author":"Steele","year":"2017","journal-title":"Morb. Mortal. Wkly. Rep."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"410","DOI":"10.1016\/j.cub.2015.12.046","article-title":"Constrained Total Energy Expenditure and Metabolic Adaptation to Physical Activity in Adult Humans","volume":"26","author":"Pontzer","year":"2016","journal-title":"Curr. Biol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"55","DOI":"10.15698\/cst2021.05.248","article-title":"Cellular mechanisms linking cancers to obesity","volume":"5","author":"Liu","year":"2021","journal-title":"Cell Stress"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"20180103","DOI":"10.1515\/pp-2018-0103","article-title":"Hypoxia, cytokines and stromal recruitment: Parallels between pathophysiology of encapsulating peritoneal sclerosis, endometriosis and peritoneal metastasis","volume":"3","author":"Wilson","year":"2018","journal-title":"Pleura Peritoneum"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1158\/2326-6066.CIR-14-0209","article-title":"Tumors: Wounds That Do Not Heal\u2014Redux","volume":"3","author":"Dvorak","year":"2015","journal-title":"Cancer Immunol. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/S0140-6736(00)04046-0","article-title":"Inflammation and cancer: Back to Virchow?","volume":"357","author":"Balkwill","year":"2001","journal-title":"Lancet"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.1056\/NEJM198612253152606","article-title":"Tumors: Wounds that do not heal. Similarities between tumor stroma generation and wound healing","volume":"315","author":"Dvorak","year":"1986","journal-title":"N. Engl. J. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"43","DOI":"10.3389\/fcell.2015.00043","article-title":"Cancer as a mitochondrial metabolic disease","volume":"3","author":"Seyfried","year":"2015","journal-title":"Front. Cell Dev. Biol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1323","DOI":"10.1002\/oby.23444","article-title":"Metabolic dysfunction and obesity-related cancer: Beyond obesity and metabolic syndrome","volume":"30","author":"Karra","year":"2022","journal-title":"Obesity"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Murphy, N., Cross, A.J., Abubakar, M., Jenab, M., Aleksandrova, K., Boutron-Ruault, M.-C., Dossus, L., Racine, A., K\u00fchn, T., and Katzke, V.A. (2016). A Nested Case\u2013Control Study of Metabolically Defined Body Size Phenotypes and Risk of Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC). PLoS Med., 13.","DOI":"10.1371\/journal.pmed.1001988"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1136","DOI":"10.1183\/09031936.00151110","article-title":"Metabolic syndrome, insulin resistance and sleepiness in real-life obstructive sleep apnoea","volume":"39","author":"Bonsignore","year":"2011","journal-title":"Eur. Respir. J."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Vicks, W.S., Lo, J.C., Guo, L., Rana, J.S., Zhang, S., Ramalingam, N.D., and Gordon, N.P. (2022). Prevalence of prediabetes and diabetes vary by ethnicity among U.S. Asian adults at healthy weight, overweight, and obesity ranges: An electronic health record study. BMC Public Health, 22.","DOI":"10.1186\/s12889-022-14362-8"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Greene, M.W., Abraham, P.T., Kuhlers, P.C., Lipke, E.A., Heslin, M.J., Wijaya, S.T., and Odeniyi, I. (2022). Consensus molecular subtype differences linking colon adenocarcinoma and obesity revealed by a cohort transcriptomic analysis. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0268436"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"370","DOI":"10.1016\/j.pulmoe.2020.05.012","article-title":"Effectiveness of different treatments in obesity hypoventilation syndrome","volume":"26","author":"Molina","year":"2020","journal-title":"Pulmonology"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1113","DOI":"10.1152\/physrev.00021.2017","article-title":"Food Intake and Eating Behavior after Bariatric Surgery","volume":"98","author":"Docherty","year":"2018","journal-title":"Physiol. Rev."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Zelicha, H., Kloting, N., Kaplan, A., Meir, A.Y., Rinott, E., Tsaban, G., Chassidim, Y., Bluher, M., Ceglarek, U., and Isermann, B. (2022). The effect of high-polyphenol Mediterranean diet on visceral adiposity: The DIRECT PLUS randomized controlled trial. BMC Med., 20.","DOI":"10.1186\/s12916-022-02525-8"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.clnesp.2022.03.020","article-title":"Understanding weight regain after a nutritional weight loss intervention: Systematic review and meta-analysis","volume":"49","author":"Machado","year":"2022","journal-title":"Clin. Nutr. ESPEN"},{"key":"ref_27","unstructured":"Sombra, L.R.S., and Anastasopoulou, C. (2022). Pharmacologic Therapy for Obesity, StatPearls Publishing. Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK562269\/."},{"key":"ref_28","first-page":"201","article-title":"Anti-obesity drug discovery: Advances and challenges","volume":"21","author":"DiMarchi","year":"2021","journal-title":"Nat. Rev. Drug Discov."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4158\/GL-2019-0406","article-title":"Clinical Practice Guidelines for the Perioperative Nutrition, Metabolic, and Nonsurgical Support of Patients Undergoing Bariatric Procedures\u20142019 Update: Cosponsored by American Association of Clinical Endocrinologists\/American College of Endocrinology, The Obesity Society, American Society for Metabolic & Bariatric Surgery, Obesity Medicine Association, and American Society of Anesthesiologists","volume":"25","author":"Mechanick","year":"2019","journal-title":"Endocr. Pr."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"530","DOI":"10.3389\/fendo.2018.00530","article-title":"Weight-Independent Mechanisms of Glucose Control after Roux-en-Y Gastric Bypass","volume":"9","author":"Pattou","year":"2018","journal-title":"Front. Endocrinol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1038\/s41366-018-0126-x","article-title":"Ghrelin reductions following bariatric surgery were associated with decreased resting state activity in the hippocampus","volume":"43","author":"Zhang","year":"2018","journal-title":"Int. J. Obes."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Zunica, E.R.M., Heintz, E.C., Axelrod, C.L., and Kirwan, J.P. (2022). Obesity Management in the Primary Prevention of Hepatocellular Carcinoma. Cancers, 14.","DOI":"10.3390\/cancers14164051"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"S13","DOI":"10.21037\/atm.2019.09.26","article-title":"Impact of bariatric surgery on cancer risk reduction","volume":"8","author":"Bruno","year":"2020","journal-title":"Ann. Transl. Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1002\/eat.23224","article-title":"Prevention of eating disorders at universities: A systematic review and meta-analysis","volume":"53","author":"Harrer","year":"2020","journal-title":"Int. J. Eat. Disord."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: A tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"ref_37","unstructured":"Higgins, J.P.T., Thomas, J., Chandler, J., Cumpston, M., Li, T., Page, M.J., and Welch, V.A. (2022). Cochrane Handbook for Systematic Reviews of Interventions Version 6.3 (Updated February 2022), Cochrane."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2423","DOI":"10.1001\/jama.2022.9009","article-title":"Association of Bariatric Surgery with Cancer Risk and Mortality in Adults with Obesity","volume":"327","author":"Aminian","year":"2022","journal-title":"JAMA"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1093\/bjs\/znac003","article-title":"Effect of bariatric surgery on cancer risk: Results from an emulated target trial using population-based data","volume":"109","author":"Lazzati","year":"2022","journal-title":"Br. J. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/SLA.0000000000005035","article-title":"Association of Bariatric Surgery and Risk of Cancer in Patients with Morbid Obesity","volume":"275","author":"Khalid","year":"2021","journal-title":"Ann. Surg."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"4015","DOI":"10.1007\/s11695-021-05511-w","article-title":"The Bariatric Surgery Is Associated with a Lower Incidence of Malignancy: Real World Data from Taiwan","volume":"31","author":"Kao","year":"2021","journal-title":"Obes. Surg."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1586","DOI":"10.1016\/j.soard.2020.06.026","article-title":"Development of cancer after bariatric surgery","volume":"16","author":"Tsui","year":"2020","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3761","DOI":"10.1007\/s11695-020-04751-6","article-title":"Cancer Risk after Bariatric Surgery in a Cohort Study from the Five Nordic Countries","volume":"30","author":"Tao","year":"2020","journal-title":"Obes. Surg."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1097\/SLA.0000000000002525","article-title":"Bariatric Surgery and the Risk of Cancer in a Large Multisite Cohort","volume":"269","author":"Schauer","year":"2019","journal-title":"Ann. Surg."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1650","DOI":"10.1002\/bjs.10914","article-title":"Obesity surgery and risk of cancer","volume":"105","author":"Mackenzie","year":"2018","journal-title":"Br. J. Surg."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1186\/s12933-018-0801-1","article-title":"A 23-year study of mortality and development of co-morbidities in patients with obesity undergoing bariatric surgery (laparoscopic gastric banding) in comparison with medical treatment of obesity","volume":"17","author":"Pontiroli","year":"2018","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Douglas, I.J., Bhaskaran, K., Batterham, R.L., and Smeeth, L. (2015). Bariatric Surgery in the United Kingdom: A Cohort Study of Weight Loss and Clinical Outcomes in Routine Clinical Care. PLoS Med., 12.","DOI":"10.1371\/journal.pmed.1001925"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1111\/joim.12012","article-title":"Review of the key results from the Swedish Obese Subjects (SOS) trial\u2014A prospective controlled intervention study of bariatric surgery","volume":"273","year":"2013","journal-title":"J. Intern. Med."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"796","DOI":"10.1038\/oby.2008.610","article-title":"Cancer Incidence and Mortality after Gastric Bypass Surgery","volume":"17","author":"Adams","year":"2009","journal-title":"Obesity"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"691","DOI":"10.1016\/j.soard.2008.08.025","article-title":"Bariatric surgery reduces cancer risk in morbidly obese patients","volume":"4","author":"Christou","year":"2008","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"694","DOI":"10.7326\/M19-3925","article-title":"Association Between Bariatric Surgery and All-Cause Mortality: A Population-Based Matched Cohort Study in a Universal Health Care System","volume":"173","author":"Doumouras","year":"2020","journal-title":"Ann. Intern. Med."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.soard.2016.10.007","article-title":"Overall and cause-specific mortality after Roux-en-Y gastric bypass surgery: A nationwide cohort study","volume":"13","author":"Gribsholt","year":"2017","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1016\/j.ygyno.2017.02.036","article-title":"Long-term incidence of female-specific cancer after bariatric surgery or usual care in the Swedish Obese Subjects Study","volume":"145","author":"Anveden","year":"2017","journal-title":"Gynecol. Oncol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1007\/s11695-022-05946-9","article-title":"Bariatric Surgery and Breast Cancer Incidence: A Population-Based, Matched Cohort Study","volume":"32","author":"Doumouras","year":"2022","journal-title":"Obes. Surg."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"4267","DOI":"10.1007\/s00464-020-07915-8","article-title":"The risk of female-specific cancer after bariatric surgery in the state of New York","volume":"35","author":"Tsui","year":"2020","journal-title":"Surg. Endosc."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1097\/SLA.0000000000003331","article-title":"Bariatric Surgery is Associated with Reduced Risk of Breast Cancer in Both Premenopausal and Postmenopausal Women","volume":"272","author":"Feigelson","year":"2019","journal-title":"Ann. Surg."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1007\/s11695-018-3598-9","article-title":"Overall and Estrogen Receptor\u2013Positive Breast Cancer Incidences Are Decreased Following Bariatric Surgery","volume":"29","author":"Hassinger","year":"2018","journal-title":"Obes. Surg."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"2880","DOI":"10.1007\/s11695-022-06155-0","article-title":"Colorectal Cancer Risk Is Impacted by Sex and Type of Surgery after Bariatric Surgery","volume":"32","author":"Hussan","year":"2022","journal-title":"Obes. Surg."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Taube, M., Peltonen, M., Sj\u00f6holm, K., Palmqvist, R., Andersson-Assarsson, J.C., Jacobson, P., Svensson, P.-A., and Carlsson, L.M.S. (2021). Long-term incidence of colorectal cancer after bariatric surgery or usual care in the Swedish Obese Subjects study. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0248550"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1001\/jamasurg.2020.0089","article-title":"Colorectal Cancer Risk Following Bariatric Surgery in a Nationwide Study of French Individuals with Obesity","volume":"155","author":"Bailly","year":"2020","journal-title":"JAMA Surg."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1016\/j.surg.2019.03.013","article-title":"Bariatric surgery is independently associated with a decrease in the development of colorectal lesions","volume":"166","author":"Kwak","year":"2019","journal-title":"Surgery"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/j.canep.2018.01.002","article-title":"Obesity surgery and risk of colorectal and other obesity-related cancers: An English population-based cohort study","volume":"53","author":"Aravani","year":"2018","journal-title":"Cancer Epidemiol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1097\/SLA.0b013e318288463a","article-title":"Increased Risk of Colorectal Cancer after Obesity Surgery","volume":"258","author":"Derogar","year":"2013","journal-title":"Ann. Surg."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1016\/j.soard.2020.12.011","article-title":"Esophageal cancer after sleeve gastrectomy: A population-based comparative cohort study","volume":"17","author":"Andalib","year":"2020","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.soard.2015.09.016","article-title":"Esophageal adenocarcinoma after obesity surgery in a population-based cohort study","volume":"13","author":"Tao","year":"2017","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1053\/j.gastro.2021.03.021","article-title":"Bariatric Surgery Reduces Cancer Risk in Adults with Nonalcoholic Fatty Liver Disease and Severe Obesity","volume":"161","author":"Rustgi","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1016\/j.amjsurg.2019.09.006","article-title":"Bariatric surgery is associated with reduction in non-alcoholic steatohepatitis and hepatocellular carcinoma: A propensity matched analysis","volume":"219","author":"Kwak","year":"2019","journal-title":"Am. J. Surg."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"696","DOI":"10.1007\/s11695-016-2051-1","article-title":"Bariatric Surgery and Liver Cancer in a Consortium of Academic Medical Centers","volume":"26","author":"Yang","year":"2016","journal-title":"Obes. Surg."},{"key":"ref_69","first-page":"102","article-title":"Potential beneficial effects of bariatric surgery on the prevalence of kidney cancer: A national database study","volume":"18","author":"Funes","year":"2021","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_70","first-page":"184","article-title":"Dynamics of adipose tissue macrophage populations after gastric bypass surgery","volume":"31","author":"Lehenkari","year":"2022","journal-title":"Obesity"},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1007\/s11095-020-02941-6","article-title":"Exosomal Secretion of Adipose Tissue during Various Physiological States","volume":"37","author":"Quan","year":"2020","journal-title":"Pharm. Res."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"2537","DOI":"10.1210\/en.2009-0070","article-title":"Obesity and Breast Cancer: The Estrogen Connection","volume":"150","author":"Cleary","year":"2009","journal-title":"Endocrinology"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1016\/j.soard.2020.08.028","article-title":"Recent advances in the mechanisms underlying the beneficial effects of bariatric and metabolic surgery","volume":"17","author":"Xu","year":"2020","journal-title":"Surg. Obes. Relat. Dis."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"705911","DOI":"10.3389\/fonc.2021.705911","article-title":"Obesity and Breast Cancer: A Paradoxical and Controversial Relationship Influenced by Menopausal Status","volume":"11","author":"Calvo","year":"2021","journal-title":"Front. Oncol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.ebiom.2018.02.022","article-title":"Obesity and Cancer: Existing and New Hypotheses for a Causal Connection","volume":"30","author":"Stone","year":"2018","journal-title":"EBioMedicine"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"2115","DOI":"10.1007\/s00394-022-02797-z","article-title":"Dietary glycemic index, glycemic load and cancer risk: A meta-analysis of prospective cohort studies","volume":"61","author":"Long","year":"2022","journal-title":"Eur. J. Nutr."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"213","DOI":"10.3389\/fendo.2020.00213","article-title":"Obesity Surgery and Cancer: What Are the Unanswered Questions?","volume":"11","author":"Casella","year":"2020","journal-title":"Front. Endocrinol."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"820968","DOI":"10.3389\/fonc.2022.820968","article-title":"Advances in the Prevention and Treatment of Obesity-Driven Effects in Breast Cancers","volume":"12","author":"Chen","year":"2022","journal-title":"Front. Oncol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1038\/s41416-021-01393-y","article-title":"Targeting obesity-related dysfunction in hormonally driven cancers","volume":"125","author":"Rubinstein","year":"2021","journal-title":"Br. J. Cancer"},{"key":"ref_80","doi-asserted-by":"crossref","unstructured":"Hsu, K.-J., Liao, C.-D., Tsai, M.-W., and Chen, C.-N. (2019). Effects of Exercise and Nutritional Intervention on Body Composition, Metabolic Health, and Physical Performance in Adults with Sarcopenic Obesity: A Meta-Analysis. Nutrients, 11.","DOI":"10.3390\/nu11092163"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1186\/bcr425","article-title":"The role of cytokines in regulating estrogen synthesis: Implications for the etiology of breast cancer","volume":"4","author":"Purohit","year":"2002","journal-title":"Breast Cancer Res."},{"key":"ref_82","first-page":"65","article-title":"Mechanisms Linking Excess Adiposity and Carcinogenesis Promotion","volume":"5","author":"Catalan","year":"2014","journal-title":"Front. Endocrinol."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"4","DOI":"10.3892\/ije.2021.4","article-title":"Paradoxical effects of obesity on pre- vs. post-menopausal breast cancer: The epigenetic mechanisms (Review)","volume":"1","author":"Frederick","year":"2021","journal-title":"Int. J. Epigenetics"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1007\/s13304-021-01162-9","article-title":"Clinical epigenetics and restoring of metabolic health in severely obese patients undergoing batriatric and metabolic surgery","volume":"74","author":"Faenza","year":"2021","journal-title":"Updat. Surg."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Verde, L., Dalamaga, M., Cap\u00f3, X., Annunziata, G., Hassapidou, M., Docimo, A., Savastano, S., Colao, A., Muscogiuri, G., and Barrea, L. (2022). The Antioxidant Potential of the Mediterranean Diet as a Predictor of Weight Loss after a Very Low-Calorie Ketogenic Diet (VLCKD) in Women with Overweight and Obesity. Antioxidants, 12.","DOI":"10.3390\/antiox12010018"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"106461","DOI":"10.1016\/j.phrs.2022.106461","article-title":"Critical review on anti-obesity effects of phytochemicals through Wnt\/\u03b2-catenin signaling pathway","volume":"184","author":"Luo","year":"2022","journal-title":"Pharmacol. Res."},{"key":"ref_87","unstructured":"World Cancer Research Fund\/American Institute for Cancer Research (2018). Continuous Update Project Expert Report: Diet, Nutrition, Physical Activity and Colorectal Cancer, World Cancer Research Fund\/American Institute for Cancer Research."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1093\/ajcn\/nqaa161","article-title":"Whole grain and dietary fiber intake and risk of colorectal cancer in the NIH-AARP Diet and Health Study cohort","volume":"112","author":"Hullings","year":"2020","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"587","DOI":"10.1002\/oby.23369","article-title":"Obesity and breast cancer: Preventive and therapeutic possibilities for bariatric surgery","volume":"30","author":"Crafts","year":"2022","journal-title":"Obesity"},{"key":"ref_90","first-page":"17472","article-title":"Role of Gut Microbiota Dysbiosis in Breast Cancer and Novel Approaches in Prevention, Diagnosis, and Treatment","volume":"13","author":"Ruo","year":"2021","journal-title":"Cureus"},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"631552","DOI":"10.3389\/fcell.2021.631552","article-title":"The Role of Gut Microbial \u03b2-Glucuronidase in Estrogen Reactivation and Breast Cancer","volume":"9","author":"Sui","year":"2021","journal-title":"Front. Cell Dev. Biol."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"18586","DOI":"10.1074\/jbc.RA119.010950","article-title":"Gut microbial \u03b2-glucuronidases reactivate estrogens as components of the estrobolome that reactivate estrogens","volume":"294","author":"Ervin","year":"2019","journal-title":"J. Biol. Chem."},{"key":"ref_93","first-page":"djv147","article-title":"Investigation of the Association between the Fecal Microbiota and Breast Cancer in Postmenopausal Women: A Population-Based Case-Control Pilot Study","volume":"107","author":"Goedert","year":"2015","journal-title":"Gynecol. Oncol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"813745","DOI":"10.3389\/fonc.2022.813745","article-title":"Secondary Bile Acids and Tumorigenesis in Colorectal Cancer","volume":"12","author":"Liu","year":"2022","journal-title":"Front. Oncol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1016\/j.mrrev.2004.08.001","article-title":"Bile acids as carcinogens in human gastrointestinal cancers","volume":"589","author":"Bernstein","year":"2005","journal-title":"Mutat. Res. Mutat. Res."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1007\/s00018-022-04278-2","article-title":"The role of bile acids in carcinogenesis","volume":"79","author":"Rozman","year":"2022","journal-title":"Cell. Mol. Life Sci."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1249\/JES.0000000000000253","article-title":"Exercise Is Key to Sustaining Metabolic Gains after Bariatric Surgery","volume":"49","author":"Gualano","year":"2021","journal-title":"Exerc. Sport Sci. Rev."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/S0140-6736(20)32649-0","article-title":"Metabolic surgery versus conventional medical therapy in patients with type 2 diabetes: 10-year follow-up of an open-label, single-centre, randomised controlled trial","volume":"397","author":"Mingrone","year":"2021","journal-title":"Lancet"},{"key":"ref_99","doi-asserted-by":"crossref","unstructured":"\u0160ebunova, N., \u0160t\u0161epetova, J., Kullisaar, T., Suija, K., R\u00e4tsep, A., Junkin, I., Soeorg, H., Lember, M., Sillakivi, T., and M\u00e4ndar, R. (2022). Changes in adipokine levels and metabolic profiles following bariatric surgery. BMC Endocr. Disord., 22.","DOI":"10.1186\/s12902-022-00942-7"},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"4008","DOI":"10.1007\/s11695-019-04089-8","article-title":"Non-responders after Gastric Bypass Surgery for Morbid Obesity: Peptide Hormones and Glucose Homeostasis","volume":"29","author":"Sima","year":"2019","journal-title":"Obes. Surg."},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"S52","DOI":"10.1002\/oby.22002","article-title":"Association between Weight Loss and the Risk of Cancer after Bariatric Surgery","volume":"25","author":"Schauer","year":"2017","journal-title":"Obesity"},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1016\/j.mam.2017.11.010","article-title":"Extracellular vesicles in obesity and diabetes mellitus","volume":"60","author":"Pardo","year":"2018","journal-title":"Mol. Asp. Med."},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"4069","DOI":"10.1007\/s00464-021-08329-w","article-title":"Factors associated with weight regain post-bariatric surgery: A systematic review","volume":"35","author":"Athanasiadis","year":"2021","journal-title":"Surg. Endosc."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"773","DOI":"10.1007\/s11154-021-09701-w","article-title":"Computational approaches to predicting treatment response to obesity using neuroimaging","volume":"23","author":"Kozarzewski","year":"2021","journal-title":"Rev. Endocr. Metab. Disord."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"1031","DOI":"10.1007\/s11695-018-3501-8","article-title":"Cancer Risk Following Bariatric Surgery\u2014Systematic Review and Meta-analysis of National Population-Based Cohort Studies","volume":"29","author":"Wiggins","year":"2018","journal-title":"Obes. Surg."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1093\/bjs\/znac343","article-title":"Risk of non-hormonal cancer after bariatric surgery: Meta-analysis of retrospective observational studies","volume":"110","author":"Clapp","year":"2022","journal-title":"Br. J. Surg."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1007\/s11695-019-04368-4","article-title":"Effects of Bariatric Surgery on Cancer Risk: Evidence from Meta-analysis","volume":"30","author":"Zhang","year":"2019","journal-title":"Obes. Surg."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/j.amjsurg.2021.03.016","article-title":"The effect of bariatric surgery on breast cancer incidence and characteristics: A meta-analysis and systematic review","volume":"222","author":"Lovrics","year":"2021","journal-title":"Am. J. Surg."},{"key":"ref_109","first-page":"444","article-title":"Association of Bariatric Surgery with Cancer Incidence in Patients with Obesity and Diabetes: Long-term Results from the Swedish Obese Subjects Study","volume":"45","author":"Carlsson","year":"2021","journal-title":"Diabetes Care"},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/1178223419898458","article-title":"Linkage between Obesity Leptin and Breast Cancer","volume":"14","author":"Atoum","year":"2020","journal-title":"Breast Cancer Basic Clin. Res."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1007\/s10654-018-0380-1","article-title":"Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: A systematic review and dose response meta-analysis","volume":"33","author":"Patterson","year":"2018","journal-title":"Eur. J. Epidemiol."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1210\/jc.2015-3444","article-title":"Body Mass Index and Risk of Nonalcoholic Fatty Liver Disease: Two Electronic Health Record Prospective Studies","volume":"101","author":"Loomis","year":"2016","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_113","doi-asserted-by":"crossref","unstructured":"Alexander, M., Loomis, A.K., van der Lei, J., Duarte-Salles, T., Prieto-Alhambra, D., Ansell, D., Pasqua, A., Lapi, F., Rijnbeek, P., and Mosseveld, M. (2019). Risks and clinical predictors of cirrhosis and hepatocellular carcinoma diagnoses in adults with diagnosed NAFLD: Real-world study of 18 million patients in four European cohorts. BMC Med., 17.","DOI":"10.1186\/s12916-019-1321-x"},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1111\/apt.14261","article-title":"Temporal trends, clinical patterns and outcomes of NAFLD-related HCC in patients undergoing liver resection over a 20-year period","volume":"46","author":"Pais","year":"2017","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1111\/apt.16335","article-title":"Systematic review with meta-analysis: Bariatric surgery reduces the incidence of hepatocellular carcinoma","volume":"53","author":"Ramai","year":"2021","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"4298","DOI":"10.3748\/wjg.v27.i27.4298","article-title":"Pancreatic cancer: A review of epidemiology, trend, and risk factors","volume":"27","author":"Hu","year":"2021","journal-title":"World J. Gastroenterol."},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/S0140-6736(08)60269-X","article-title":"Body-mass index and incidence of cancer: A systematic review and meta-analysis of prospective observational studies","volume":"371","author":"Renehan","year":"2008","journal-title":"Lancet"},{"key":"ref_118","unstructured":"(2022, January 07). Obesity and Cancer, Available online: https:\/\/www.cancer.gov\/about-cancer\/causes-prevention\/risk\/obesity\/obesity-fact-sheet."},{"key":"ref_119","first-page":"1156","article-title":"Body Mass Index and Risk of Second Cancer among Women with Breast Cancer","volume":"113","author":"Feigelson","year":"2021","journal-title":"Gynecol. Oncol."},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"2521","DOI":"10.1001\/jama.2020.23130","article-title":"Association of First Primary Cancer with Risk of Subsequent Primary Cancer among Survivors of Adult-Onset Cancers in the United States","volume":"324","author":"Sung","year":"2020","journal-title":"JAMA"},{"key":"ref_121","first-page":"1344","article-title":"Impact of Obesity on Cancer Survivorship and the Potential Relevance of Race and Ethnicity","volume":"105","author":"Schmitz","year":"2013","journal-title":"Gynecol. Oncol."},{"key":"ref_122","doi-asserted-by":"crossref","first-page":"741","DOI":"10.1056\/NEJMoa066254","article-title":"Effects of Bariatric Surgery on Mortality in Swedish Obese Subjects","volume":"357","author":"Narbro","year":"2007","journal-title":"N. Engl. J. Med."},{"key":"ref_123","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1016\/S1470-2045(09)70159-7","article-title":"Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): A prospective, controlled intervention trial","volume":"10","author":"Gummesson","year":"2009","journal-title":"Lancet Oncol."},{"key":"ref_124","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1097\/SLA.0000000000005171","article-title":"Does Bariatric Surgery Prevent Cancer?","volume":"275","author":"Chao","year":"2021","journal-title":"Ann. Surg."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"e000989","DOI":"10.1136\/bmjdrc-2019-000989","article-title":"Superior socioeconomic status in patients with type 2 diabetes having gastric bypass surgery: A case-control analysis of 10 642 individuals","volume":"8","author":"Sundbom","year":"2020","journal-title":"BMJ Open Diabetes Res. Care"},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1056\/NEJMoa2032183","article-title":"Once-Weekly Semaglutide in Adults with Overweight or Obesity","volume":"384","author":"Wilding","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1056\/NEJMoa2206038","article-title":"Tirzepatide Once Weekly for the Treatment of Obesity","volume":"387","author":"Jastreboff","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1016\/S2213-8587(22)00008-0","article-title":"Semaglutide once a week in adults with overweight or obesity, with or without type 2 diabetes in an east Asian population (STEP 6): A randomised, double-blind, double-dummy, placebo-controlled, phase 3a trial","volume":"10","author":"Kadowaki","year":"2022","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"1553","DOI":"10.1111\/dom.14725","article-title":"Weight regain and cardiometabolic effects after withdrawal of semaglutide: The STEP 1 trial extension","volume":"24","author":"Wilding","year":"2022","journal-title":"Diabetes, Obes. Metab."}],"container-title":["International Journal of Molecular Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1422-0067\/24\/7\/6192\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:02:41Z","timestamp":1760122961000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1422-0067\/24\/7\/6192"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,24]]},"references-count":129,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["ijms24076192"],"URL":"https:\/\/doi.org\/10.3390\/ijms24076192","relation":{},"ISSN":["1422-0067"],"issn-type":[{"value":"1422-0067","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,24]]}}}