GLP-1 receptor agonist use and cancer risk in obese nondiabetic adults

Author(s): A.H.-C. Hsu1,2,3,4; P.T. Ramirez1; Y.-H. Chang5; Y.-C. Chiang2,3,6; M.C. Santía7; T. Meschini8; P. Mateo-Kubach1; A. Suri1; A.A. Kamat1;
Source: DOI: 10.1016/j.annonc.2026.04.013
Original Article
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The cohort included 229 467 patients; 86 422 (37.7%) received glucagon-like peptide-1 receptor agonist (GLP-1RA), while 143 045 (62.3%) received diet or exercise consultation. With a median follow-up of 2 years (interquartile range 1-2 years), the propensity score matching analysis showed a significantly lower incidence of any Obesity Associated Cancers among GLP-1RA users (hazard ratio 0.59, 95% confidence interval 0.53-0.67). Secondary analyses showed that in all subgroups, except for black race, GLP-1RA use was associated with a lower cumulative incidence of OACs. GLP-1 will be studied more often in cancer patients, some practices, already have GLP-1 clinic as part of their cancer care.

ABSTRACT

Highlights•Obesity and OACs are increasing worldwide.•GLP-1RAs are increasingly used for obesity in nondiabetic patients.•GLP-1RAs use was associated with decreased cumulative incidence of OACs over a median follow-up of 2 years.•This is the first study to isolate the association of GLP-1RAs and cancer risk in obese individuals without diabetes.•Prospective studies with longer follow-up are required to determine whether these associations reflect a causal effect.AbstractBackgroundRecent data show that glucagon-like peptide-1 receptor agonist (GLP-1RA) use is associated with decreased cancer incidence in diabetic and obese patients. However, there have been no studies exclusively investigating the association of obesity-associated cancer (OAC) risks and GLP-1RAs in obese, nondiabetic patients.Patients and methodsWe conducted a target trial emulation to evaluate the association between GLP-1RA use and risk of 13 OACs. Using TriNetX, a nationwide database of 113 million US patients, we identified obese, nondiabetic adults without prior OAC diagnosis from December 2014 to June 2025. Patients prescribed GLP-1RAs were 1:1 propensity score matched to those receiving diet or exercise counseling and validated using inverse probability of treatment weighting. The primary outcome compared the cumulative incidence of OACs among treatment groups. The secondary outcome analyzed cancer incidence across sex (female, male), body mass index (

Author Affiliations

1Department of Obstetrics and Gynecology, Houston Methodist Hospital, Houston Methodist Neal Cancer Center, Houston, Texas, USA; 2Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei, Taiwan; 3Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan; 4Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; 5Institute of Statistics, National Yang Ming Chiao Tung University, Hsinchu, Taiwan; 6Department of Obstetrics and Gynecology, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan; 7Department of Gynecology, Hospital Italiano of Buenos Aires, Buenos Aires, Argentina; 8Department of Obstetrics and Gynecology, Women’s and Children’s Del Ponte Hospital, University of Insubria, Varese, Italy

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