journal article Open Access May 29, 2025

GLP ‐1 receptor agonists and the risk for cancer: A meta‐analysis of randomized controlled trials

Diabetes, Obesity and Metabolism Vol. 27 No. 8 pp. 4454-4468 · Wiley
View at Publisher Save 10.1111/dom.16489
Abstract
Abstract

Aims
To assess if there is a difference in the oncogenic risk between GLP‐1 RA and comparators in randomized controlled trials.


Materials and Methods
A meta‐analysis of randomized controlled trials comparing GLP‐1RA to any comparators for diabetes and/or obesity, lasting at least 52 weeks. The endpoints included the incidence of overall cancers and single malignancies.


Results
Fifty trials were included. GLP‐1RA treatment was not associated with a significant difference in risk for overall cancer (MH‐OR 1.05, 95% confidence interval [CI] [0.98, 1.13]). Uterine cancer was significantly reduced in the GLP‐1RA arm in trials performed in subjects with obesity (MH‐OR 0.24, 95% CI [0.06, 0.94]), but not in those aimed at diabetes treatment (MH‐OR 0.92, [0.58, 1.47]). We detected an increase in the risk for thyroid cancer (MH‐OR 1.55, [1.05, 2.27]), more evident in longer‐term trials, and in the risk for colorectal cancer (MH‐OR 1.27 [1.03, 1.57]), which, conversely, was significant only in shorter‐term trials. No significant difference in the risk was detected for any other cancer.


Conclusions
GLP‐1 RA do not appear to produce an effect on most malignancies in clinical trials. A reduction of very close obesity‐associated cancers seems possible, whereas a risk signal for thyroid cancer was observed, prompting the need for further specific studies. On the other hand, the small increase observed in colorectal cancer in shorter‐term trials may be the effect of a disproportionate increase in diagnostic procedures in the GLP‐1 RA arm, because of the suspicion raised by common side effects of GLP‐1 RA.
Topics

No keywords indexed for this article. Browse by subject →

References
103
[8]
Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms

Eugenia E. Calle, Rudolf Kaaks

Nature Reviews Cancer 10.1038/nrc1408
[18]
Emerging Role of GLP-1 Agonists in Obesity: A Comprehensive Review of Randomised Controlled Trials

Mihaela-Simona Popoviciu, Lorena Păduraru, Galal Yahya et al.

International Journal of Molecular Sciences 10.3390/ijms241310449
[23]
US Food and Drug Administration.Ozempic Medication Guide. n.d.
[24]
European Medicine Agency.Ozempic: EPAR – Product information. n.d.
[33]
Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes

A. Michael Lincoff, Kirstine Brown-Frandsen, Helen M. Colhoun et al.

New England Journal of Medicine 10.1056/nejmoa2307563
[35]
PROSPERO database.https://www.crd.york.ac.uk/prosperon.d.
[37]
RoB 2: a revised tool for assessing risk of bias in randomised trials

Jonathan A C Sterne, Jelena Savović, Matthew J Page et al.

BMJ 10.1136/bmj.l4898

Showing 50 of 103 references