In Adults With Obesity, GLP-1 Receptor Agonists May Reduce Risk for Cancer

Glucagon-like peptide-1 receptor agonists (GLP-1s) appear to reduce the risk of several cancers among adults with obesity, according to findings from a large retrospective cohort study published in JAMA Oncology. Investigators reported that GLP-1 use was associated with lower overall cancer risk, with the strongest associations observed for endometrial and ovarian cancers and meningioma.¹

Accruing evidence suggests obesity is associated with at least 13 types of cancer, which account for approximately 40% of all cancer diagnoses each year in the US, according to the CDC.² As obesity rates continue to rise, identifying effective interventions to mitigate cancer risk among individuals with obesity is a critical public health priority.³

Obesity without Diabetes

Existing studies “have focused on comparisons among glucose-lowering drugs in patients with T2D, leaving uncertainty regarding their potential role in cancer prevention in individuals with obesity regardless of diabetes status,” authors wrote. “Additionally, previous studies often did not address variation in treatment effects across different patient groups, known as heterogeneity of treatment effects.”

For their analysis, lead author Jiang Bian, PhD, MS, associate dean for data science at Indiana University School of Medicine and chief data scientist for IU Health and the Regenstrief Institute, and colleagues used electronic health record data from the OneFlorida+ health research network, which covers about 10 million individuals in Florida and neighboring southern states. The final cohort, identified between January 1 and 31, 2024, included 86,632 adults meeting eligibility criteria of either obesity (body mass index [BMI] of 30 kg/m2 or greater) or overweight (BMI 27–29.9 with at least one weight-related comorbidity).

Bian et al matched 43,317 GLP-1 users to 43,315 nonusers Among all participants the mean age was 52.4 years, 68.2% were women, 44.2% were non-Hispanic White. Approximately half (48.3%) were categorized as having obesity and roughly the same proportion (50.7%) had type 2 diabetes.

Findings

Researchers compared the incidence of 14 cancer types between GLP-1 users and nonusers. They reported an incidence rate for all 14 of 13.6 per 1,000 persons for GLP-1 users compared with 16.2 per 1,000 persons for nonusers. The overall hazard ratio (HR) for cancer among the former vs the latter group was 0.83 (95% CI, 0.76–0.91; P = .002). Bian and colleagues found statistically significant reductions for 3 types of cancer:

• Endometrial cancer (HR, 0.75; 95% CI, 0.57–0.99)
• Ovarian cancer (HR, 0.53; 95% CI, 0.29–0.96)
• Meningioma (HR, 0.69; 95% CI, 0.48–0.97).

When endometrial and ovarian cancers were analyzed together, the combined hazard ratio was 0.68 (95% CI, 0.52–0.87).

Conversely, they observed a higher incidence of kidney cancer among GLP-1 users compared with nonusers, although the difference did not reach statistical significance (HR, 1.38; 95% CI, 0.99–1.93). Other documented reductions in risk, including for upper gastrointestinal, lung, and thyroid cancers, also did not achieve significance.

Effective Interventions are Needed

Bian et al noted that their study is “one of the first to assess the association between GLP-1RA use and cancer risk in the broad, real-world population with obesity or overweight who are eligible for AOM.”

“As obesity rates continue to rise, identifying effective interventions to mitigate cancer risk among individuals with obesity is a critical public health priority,” the study authors wrote. They added, “Given that more than 137 million individuals in the US are currently eligible for GLP-1RA therapies, even modest changes in cancer risk could have substantial public health implications.”

Among the study’s limitations the authors acknowledged the observational design, potential confounding factors, limited data on lifestyle variables, and relatively short follow-up for cancer outcomes.

The researchers plan to extend their analyses using statewide electronic health records to assess long-term associations and explore effects of individual GLP-1 agents rather than the class as a whole.

References

1. Dai H, Li Y, Lee YA, et al. GLP-1 receptor agonists and cancer risk in adults with obesity. JAMA Oncol. Published online August 21, 2025. doi:10.1001/jamaoncol.2025.2681

2. Obesity and cancer. Centers for Disease Control and Prevention. June 11, 2025.Accessed August 22, 2025, 2025. https://www.cdc.gov/cancer/risk-factors/obesity.html

3. Peralta M, Ramos M, Lipert A, Martins J, Marques A. Prevalence and trends of overweight and obesity in older adults from 10 European countries from 2005 to 2013. Scand J Public Health. 2018;46(5):522-529. doi:10.1177/1403494818764810