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More Data on GLP-1 Receptor Agonist Use and Cancer Risk
Glucagon-like peptide-1 (GLP-1) receptor agonists have been linked to excess risk for some cancers (e.g., the U.S. FDA labels for these drugs note possible excess risk for thyroid cancer). However, weight loss with these drugs also could lower risk for obesity-related cancers.* Three large observational studies provide more data.
- In a U.S. study of patients with obesity, overall incidence of obesity-related cancer was lower in patients who received GLP-1 agonists than in those who didn't (14 vs. 16 cancers per 1000 person-years). Risk was lower for endometrial and ovarian cancers and meningiomas, but kidney cancer was more common in GLP-1 recipients.
- In a 15-year U.S. study of older patients with type 2 diabetes, obesity-related cancer incidence was similar in patients prescribed GLP-1 agonists (without metformin) and in those prescribed metformin (without GLP-1 agonists). The only cancer-specific risk difference was a higher likelihood of kidney cancer with GLP-1 use.
- In a 10-year Danish study of patients with type 2 diabetes, risk for cancer was 4 percentage points higher among users of GLP-1 agonists than among users of dipeptidyl peptidase-4 inhibitors (25% vs. 21%). The only cancer-specific risk difference was a heightened incidence of uterine cancer in GLP-1 recipients.
Comment
The lower incidence of obesity-associated cancers in obese patients in the first study was remarkable; however, this finding was not observed in the two studies that focused on patients with diabetes. More troubling, in the Danish study, researchers examined all cancers (not just obesity-related cancers) and found higher risks with GLP-1 use. None of the studies showed excess risk for thyroid cancer, but the higher risk for renal cancer in two studies deserves further investigation. Reasonable people might disagree on how to interpret these data. My take is that we have not ruled out the possibility of a small excess cancer risk with long-term use of these drugs.
Bio
*Examples of obesity-related cancers are breast, thyroid, endometrial, ovarian, kidney, and colorectal cancers.
Citation(s)
Author:
Dai H et al.
Title:
GLP-1 receptor agonists and cancer risk in adults with obesity.
Source:
JAMA Oncol
2025
Aug
21; [e-pub].
(Abstract/FREE Full Text)
Author:
Lu Y et al.
Title:
Association of glucagon-like peptide-1 receptor agonists with cancer risk in older adults with type 2 diabetes.
Source:
Obesity
2025
Aug
21; [e-pub].
(Abstract/FREE Full Text)
Author:
Gamborg M et al.
Title:
Long-term cancer risk in users of GLP-1 agonists in Denmark: A nationwide emulated trial.
Source:
Lancet Res Health Eur
2025
Aug
; [e-pub].
(Abstract/FREE Full Text)
Empfohlen von
Christopher W. Goodman, MD