Glucagon-like peptide-1 receptor agonists and the risk of obesity-related cancers: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of randomized controlled trials and observational studies
PubMed 41722869 · doi:10.1016/j.diabres.2026.113158
What was done
Authors conducted a systematic review and meta-analysis searching Embase, PubMed, and Cochrane CENTRAL through November 20, 2025. They included observational studies and randomized controlled trials of adults (≥18 years) with type 2 diabetes mellitus and/or obesity evaluating cancer risk after use of GLP-1 receptor agonists or GIP/GLP-1 receptor co-agonists across 14 predefined obesity-related cancer types.
What was found
Across 24 studies including 3,960,974 patients, GLP-1RA use was associated with a significantly lower overall risk of obesity-related cancers within ten years (RR 0.70, 95% CI 0.54–0.89). Risk was reported as decreased for hepatocellular carcinoma, colorectal, pancreatic, endometrial, esophageal, gallbladder, and ovarian cancers, and multiple myeloma, but individual numerical estimates and confidence intervals for these subtypes were not provided in the abstract. No significant association was observed for thyroid cancer.
Why it matters
This large meta-analysis provides evidence that GLP-1RA therapy is associated with a reduced overall risk of obesity-related malignancies over up to ten years, addressing a key clinical safety and outcome question.
Limits
The review combines observational studies with randomized controlled trials without reporting design-specific subgroup results or heterogeneity metrics in the abstract. Specific effect estimates and confidence intervals for individual cancer subtypes are not provided, and confounding by degree of weight loss, glycemic control, or baseline screening cannot be assessed from the abstract.
Cited by
- supports Long-term data on older GLP-1 agonists like liraglutide and exenatide show no increased risk of cancer-related mortality.