GLP-1 Receptor Agonists and Cancer Risk in Adults With Obesity

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely prescribed for glycemic control in type 2 diabetes and have recently gained popularity for weight management. However, their long-term impact on cancer risk remains uncertain. Understanding this association is crucial for patient safety.

To compare the incidence of 14 cancers among adults with obesity prescribed GLP-1RAs vs nonusers. Design, Setting, and Participants: This retrospective cohort study followed a target trial emulation design using 2014 to 2024 electronic health record data from OneFlorida+, a multicenter health research network that integrates real-world clinical data from diverse health care settings. Adults 18 years or older eligible for antiobesity medications without prior cancer history were included. Participants were categorized as GLP-1RA users or nonusers, matched 1:1 using propensity scores. Exposure: Individuals taking vs not taking GLP-1RAs. Main Outcomes and Measures: The primary outcomes were the incidence of 14 cancer types, including 13 obesity-associated cancers (liver, thyroid, pancreatic, bladder, colorectal, kidney, breast, endometrial, meningioma, upper gastrointestinal, ovarian, multiple myeloma, and prostate) and lung cancer.