GLP-1s Linked to 41% Drop in Cancer Risk in Nondiabetic Adults

This transcript has been edited for clarity. Hello. I’m Dr Maurie Markman, from City of Hope.

I’d like to discuss a very interesting paper, one that is getting a large amount of press. It’s just one of many papers, but I think this is a relevant paper. It’s titled, “ GLP-1 Receptor Agonist Use and Cancer Risk in Obese Nondiabetic Adults .” As I’ve noted, the topic of GLP-1 use and its very favorable impact on health is well established, including in the suggestion that risk for cancer will be decreased.

This particular analysis, which is one of few so far in this area, is looking at the impact of the use of this class of drugs on an obese population that is nondiabetic. As most listeners know, the first use of these agents was in the obese diabetic patient population. The question being addressed here is, do we have data to suggest outside of diabetes, specifically in obesity , is there a favorable impact of GLP-1 agonists in reducing that risk for cancer?

What is being looked at here is a very large national database, TriNetX, that includes 113 million patients in the United States, and looking specifically at the risk for 13 obesity-associated cancers. Again, these are individuals who are obese but do not have evidence of diabetes.

They looked at a population in this database from December 2014 to June 2025. The analysis was 1:1 propensity scores; the populations included those who were receiving diet or exercise counseling as their intervention as a background control vs a population of individuals who received GLP-1 receptor agonists.

There were 229,467 patients without a prior history of cancer who were obese, 37.7% of which (or approximately one third) received one of these agents. A total of 161,798 were included in this analysis — again, divided 50% who received the drugs and 50% who did not. The mean age of the population was 47.2, with a median follow-up of 2 years.

Again, all of the individuals included in this analysis had no evidence of cancer when they started these agents, at least in terms of the documentation in the database. The investigators found, interestingly and strikingly, a hazard ratio of 0.59 or 41% reduction in the risk for cancer in the population of individuals who are taking a GLP-1 receptor agonist.

The short-term conclusion of the investigators is that because we are talking about only a 2-year period of their looking at the risk, the incidence of obesity-associated cancers among the obese nondiabetic patient population decreased with the use of these drugs. Now, clearly we need more data.

We ultimately need prospective trials. I would argue randomization itself is not required as long as the prospective analyses are large enough patient populations, and they’re carefully looked at to make sure the populations are relatively equivalent. The reason I say that is because the suggested reductions are so impressive in what we’re seeing here, but we do need prospective analyses rather than retrospective data — which obviously is fraught with such issues as we don’t have all the information, we may not know about comorbidities, we may not know about things like how often individuals see a doctor, do they smoke, etc.

Prospective evaluation is important, but the data right now, one would have to say, are intriguing and in fact promising. I thank you for your attention.