Impact of Bariatric Surgery on Prostate Cancer Screening Rate.

Abstract

Patients with obesity are at a greater risk of developing more aggressive forms of prostate cancer. Bariatric surgery has been demonstrated to reduce that risk; however, the exact mechanism of this protective effect is not known. We examined the relationship between bariatric surgery and prostate cancer screening rates using a national insurance database. Using the Merative MarketScan Database, 13,662 men aged 50 to 65 years in the US who underwent bariatric surgery were identified and compared with 3 control groups who did not undergo bariatric surgery, stratified by obesity diagnosis according to ICD codes. Multivariable Poisson regression was used to assess the rate of prostate cancer screening for each group, adjusting for demographic factors and comorbidities. For surgical patients, the rate of screening before bariatric surgery was 0.07 tests per person-year and improved to 0.17 tests per person-year after surgery (p < 0.001). For control groups, screening rates were 0.08, 0.13, and 0.11 tests per person-year for patients with no obesity, patients with obesity, and those with morbid obesity, respectively. The incidence rate ratio relative to the no-obesity control group (95% CI) was 1.03 (0.97 to 1.10) for the presurgery group, 2.35 (2.21 to 2.50) for the postsurgery group, 1.66 (1.59 to 1.75), and 1.54 (1.47 to 1.62) for the obesity and morbid obesity groups, respectively. The rate of men in the US undergoing prostate cancer screening identified via a large, nationwide claims database significantly increased after bariatric surgery. After their operation, the bariatric surgery patients became the most screened group. This significant increase in screening rate after bariatric surgery suggests that bariatric surgery serves as an impetus for engaging with the healthcare system across other areas of care.