Population-based cohort study of incidence of cancer and cardiovascular disease after bariatric surgery in older patients

Bariatric surgery is associated with decreased risk of obesity-related cancer (of breast, endometrium, esophagus, colorectum, and kidney) and cardiovascular disease (CVD), but is typically reserved for patients younger than 60 years. A population-based cohort study in Denmark, Finland, and Sweden included patients who underwent bariatric surgery after age 59 years, and for each patient 5 matched patients who underwent nonoperative treatment for obesity. During median 5.8 years of follow-up 4.3% developed obesity-related cancer, and 9.4% developed CVD. The risk of obesity-related cancer (HR 0.81; 95% CI 0.64-1.03) and CVD (0.86; 0.74-1.01) was not significantly different between both groups. Gastric bypass was associated with a decreased risk of obesity-related cancer (HR 0.74; 95% CI 0.56-0.97) and CVD (0.82; 0,69-0.99) compared with matched controls. The authors conclude that these finding suggest that the preventive association between bariatric surgery and obesity-related cancer and CVD may be limited to younger individuals.