For adults with obesity but without diabetes, use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) is associated with a significantly lower short-term incidence of obesity-associated cancers (OACs), according to a study published online on June 7 in the Annals of Oncology.
Arthur Heng-Cheng Hsu, Ph.D., from the Houston Methodist Neal Cancer Center, and colleagues examined the association between GLP-1 RA use and risk for 13 OACs in a target trial emulation using the TriNetX nationwide database. Adults with obesity but without diabetes and without prior OAC diagnosis were identified from December 2014 to June 2025. Patients prescribed GLP-1 RAs were propensity score-matched to those receiving diet or exercise counseling.
The cohort included 229,467 participants; 37.7 and 62.3 percent received GLP-1 RAs and diet or exercise consultation, respectively. After propensity score matching, 80,899 GLP-1 RA users were matched to 80,899 patients who received diet or exercise consultations. The researchers found that the incidence of any OAC was significantly lower among GLP-1 RA users, with a median follow-up of two years (hazard ratio, 0.59). GLP-1 RA use was associated with a lower cumulative incidence of OACs in all subgroups, except for Black race, in secondary analyses.
The findings were confirmed by inverse probability of treatment weighting.
According to the Centers for Disease Control and Prevention (CDC), Black patients often face later-stage cancer diagnoses and poorer outcomes across several obesity-associated cancers. Although this study wasn’t designed to evaluate racial disparities, clinicians should view the findings through an equity lens.
Researchers are increasingly examining whether GLP-1 therapies may offer benefits beyond weight loss, including reducing inflammation and metabolic dysfunction that contribute to cancer development.
Despite growing evidence supporting the use of GLP-1s beyond diabetes management, Black patients continue to face barriers to access, including:
With this in mind, clinicians may need to advocate for GLP-1 coverage and discuss all the available treatment options with eligible patients.
While the study’s findings are promising, they are simply observational and do not prove GLP-1 drugs directly prevent cancer. However, they add to a growing body of evidence linking GLP-1 receptor agonists to reduced risk of obesity-associated cancers and improved cancer outcomes.
For providers caring for Black patients with obesity, diabetes, or other metabolic risk factors, these medications may represent an increasingly important tool in comprehensive cancer prevention strategies.
“GLP-1 RAs are already transforming how we treat obesity,” senior author Aparna A. Kamat, M.D., from Houston Methodist Hospital, said in a statement. “What this analysis of more than 229,000 patients tells us is that their impact may reach further and transform how we think about cancer prevention.”
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