1Student of Masters in Healthcare Administration (Previous Degree: MBBS), Health Sciences, Union Commonwealth University, United States. Email: Drmalik4488@gmail.com
2Faculty of Life Sciences, Department of Pharmacy, Sarhad University of Science and Information Technology, Peshawar, Pakistan. Email: sudhair.fls@suit.edu.pk
3Doctor (MD), Department of Internal Medicine, Akhtar Saeed Medical & Dental College, Lahore, Pakistan. Email: azkaafi8978@gmail.com
4Specialist Physician, Gastroenterology, Sheikh Tahnoon Bin Mohammed Medical City, Al Ain, UAE. Email: dr_mwasim@hotmail.com
5Assistant Professor, Department of Biosciences, University of Wah, Pakistan. Email: razia.virk@uow.edu.pk
*Corresponding Author: Dr. Sudhair Abbas Bangash, Faculty of Life Sciences, Department of Pharmacy, Sarhad University of Science and Information Technology, Peshawar, Pakistan. Email: sudhair.fls@suit.edu.pk
Background: Obesity is a major cause of any GI cancers like gastric cancer. Bariatric surgery is a sustainable weight-reducing and metabolic intervention over the long term, yet the impacts of such an intervention on the occurrence of cancer in the GI are less established than the impact of non-operative management.
Objectives: The objective of the research is to perform a systematic review and meta-analysis in order to identify the long-term risk of gastric and general GI cancers in the patients who receive bariatric surgery compared to non-operative treatment.
Methods: PRISMA 2020 guidelines were followed when developing methods, which included systematic search of the PubMed/MEDLINE, Embase, Web of Science, Cochrane Library, Scopus, and ClinicalTrials.gov (PROSOPO registration is being undertaken). There were also studies on adults with obesity who underwent bariatric surgery (Roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding) and compared it with non-surgical treatment and reported incident gastric or other GI cancers compared to non-surgical treatment 5 years or longer follow-up. Two reviewers extracted data independently and assessed the quality of such data using Newcastle-Ottawa Scale of observational studies and Cochrane RoB 2.0 of randomized trials. Pooled hazard ratios (HRs) with 95% confidence intervals (CI) were calculated using random-effects models. Heterogeneity and the test of Egger and funnel plot were tested by I² test and test of Egger and funnel plot respectively.
Results: 25 articles (8,512,470 participants (1,246,320 surgery; 7,266,150 non-operative) and median follow-up 5-24 years old) were identified. Bariatric surgery decreased the risk of gastric cancer (HR 0.62; 95% CI 0.48-0.80), and overall GI cancers (HR 0.71; 95% CI 0.60-0.84) by 38 and 29 percent, respectively. The greatest risk reductions were observed after Roux-en-Y gastric bypass (HR 0.55 of gastric cancer) as well as after 10 or more years of follow-up (HR 0.57). The degree of heterogeneity was moderate (I² -gastric cancer-55%). Sensitivity analyses were used in order to verify stability of pooled estimates. The publication bias appeared not to exist (Egger p = 0.11).
Conclusions: Bariatric surgery (perioperative) is significantly lower in gastric and total GI cancer risk than no surgical intervention particularly in Roux-en-Y gastric bypass and with long term follow-up. These findings add to the oncologic and metabolic justification of bariatric surgeries and support their incorporation into the management plan as in the instance of obesity.
Keywords: The paper aims to discuss the connection between obesity and surgery in terms of bariatric surgery, gastric cancer, gastrointestinal neoplasmas, and meta-analysis head-on collisions between the Roux-en-Y gastric bypass and sleeve gastrectomy.
How to cite this article: Malik N, Bangash SA, Afi A, Wasim M, Virk R. Long-Term Risk Of Gastric (Or Gastrointestinal) Cancer Following Bariatric Surgery Compared To Non-Operative Management: A Systematic Review And Meta-Analysis. Int J Drug Deliv Technol. 2026;16(10s): 985-995. DOI: 10.25258/ijddt.16.10s.114
Source of support: Nil.
Conflict of interest: None