Impact of surgical weight loss treatments on care burden among obese endometrial cancer survivors.

Abstract

5607 Background: Among obesity-related cancers globally, 40% of disability adjusted life years lost are attributed to endometrial cancer (EC). EC patients are more likely to die of obesity-related complications rather than the cancer itself. Metabolic and bariatric surgery (MBS) is an effective weight loss treatment that has been shown to reduce prevalence and severity of many obesity-related chronic conditions. However, there is limited evidence on MBS on EC survivors. We examined the burden of patient healthcare utilization among EC survivors who did and did not undergo MBS. Methods: We utilized the SEER-Medicare database to identify 31,437 patients diagnosed with endometrial cancer between 2015 and 2017. We selected 9,229 (29.4%) patients with documented obesity (ICD codes) among whom 75 (0.8%) patients underwent MBS after completing EC treatment (2017-2019). EC survivors with and without a history of MBS were matched on age at EC diagnosis. We examined annualized Medicare inpatient and provider claims payments among EC-MBS (starting 3 months after the surgery, n=66) and EC-no MBS patients (2017-2019) and used Wilcoxon Rank-Sum tests to examine differences in payments in a 1:5 matched sample. Results: EC-MBS patients were younger (59.9 years) at the time of cancer diagnosis compared to EC-no MBS patients (68.2 years, p<0.01). In an age-matched sample, annualized median inpatient and provider claim payments among EC-MBS patients ($1,824) were lower than that of EC-no MBS patients ($2,920, p<0.01). Conclusions: Surgical weight loss achieves rapid and effective weight loss and has the potential to lower healthcare utilization among EC survivors but less than 1% of eligible patients receive the surgery. Further research is needed to better understand patient, provider, and access barriers to surgical weigh loss in patients with obesity-related cancers. [Table: see text]