Can GLP-1s Reduce Cancer Risk?

Obesity is a chronic, relapsing, metabolic disease, affecting > 40% of US adults and is associated with many other chronic illnesses. The introduction of glucagon-like peptide-1 (GLP-1) receptor agonists has revolutionized the treatment of obesity, and in addition to their use in type 2 diabetes mellitus, they have also been shown to reduce cardiovascular disease risk, improve lipid metabolism (thus lowering cholesterol levels), improve NAFLD, and reduce the risk of obesity-associated cancers. 

We’ll review obesity-associated illnesses, discuss the main benefits of GLP-1 receptor agonists, and  uncover their role in reducing the risk of obesity-associated cancers.

What are obesity-associated illnesses?

Obesity is associated with many other comorbidities or coexisting, related diseases:

• Hypertension (high blood pressure)

• Hyperlipidemia (high cholesterol)

• Type 2 diabetes mellitus

• Non-alcoholic fatty liver disease (NAFLD)

• Coronary artery disease

• Obstructive sleep apnea

• Certain cancer types

As obesity is becoming increasingly recognized as a chronic illness that can be effectively managed with various treatments, we’re also seeing improvements in these related, obesity-associated diseases. 

Benefits of GLP-1s

There are many benefits of GLP-1 receptor agonists, and ongoing research continues to identify more potential benefits:

• Blood glucose regulation

• Insulin sensitivity improvement

• Lipid metabolism improvement

• Weight loss

• Lowered inflammation

• Cardiovascular risk reduction

• Fatty liver disease treatment

• Chronic kidney disease risk reduction

• Dementia risk reduction and potential treatment

• Risk reduction of obesity-associated cancers

What are obesity-associated cancers?

There are 13 cancer types that have been determined to be obesity-associated cancers:

• Esophageal cancer

• Thyroid cancer

• Breast cancer

• Endometrial cancer

• Ovarian cancer

• Gastric (stomach) cancer

• Colorectal cancer

• Gallbladder cancer

• Hepatocellular carcinoma

• Pancreatic cancer

• Kidney cancer

• Multiple myeloma

• Meningioma

Obesity-associated cancers means that excess adiposity (body fat) increases not only the risk of developing the cancers but also worsens the prognosis of these cancer cases. This is thought to relate, in part, to the coexisting insulin resistance and chronic inflammation seen in the majority of cases of obesity.

GLP-1 receptor agonists and obesity-associated cancers 

Insulin is the oldest method of  treatment for type 2 diabetes, but it can be obesogenic;promoting weight gain, further insulin resistance, and chronic inflammation, which increases the risk of obesity-associated cancers even more. Limited data suggests that metformin, one of the earliest medications used to improve insulin sensitivity, may have a small benefit in reducing the risk of obesity associated cancers.

As research continues to uncover the benefits of GLP-1 receptor agonists, obesity-associated cancers have been a new area of study. Within a recent study, participants with type 2 diabetes and obesity were divided into groups of patients on GLP-1 receptor agonists: one group taking insulin but no GLP-1 receptor agonist and the other group taking a GLP-1 receptor agonist but no insulin. 

GLP-1 receptor agonists showed a significant risk reduction in 10 out of the 13 obesity-associated cancers:

• Esophageal

• Colorectal

• Hepatocellular

• Gallbladder

• Pancreatic

• Kidney

• Ovarian

• Endometrial

• Meningioma

• Multiple myeloma

The risk reductions of stomach cancer and thyroid cancer were not statistically significant between insulin and a GLP-1 receptor agonist. 

A separate arm of the study looked at metformin as a potential treatment for obesity associated cancers, as some research has previously done. When comparing metformin and GLP-1 receptor agonists head-to-head for the reduction in obesity-associated cancer risks, GLP-1 receptor agonists showed a benefit over metformin for lower risks of colorectal cancer, gallbladder cancer, and meningiomas, but the differences were not statistically significant. Kidney cancer risk was actually higher with the use of GLP-1 receptor agonists as opposed to metformin. 

What we need to still learn

The study referenced above was an observational study, not a randomized-controlled trial, so additional research is necessary to confirm these benefits and help guide the impact this will have on obesity treatment and cancer prevention. 

In addition, research is ongoing to discover additional potential uses and benefits of GLP-1 receptor agonists. Here are examples of potential treatment uses, for which GLP-1 receptor agonists are not currently FDA-approved:

• Dementia

• Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH)

• Alcohol abuse disorder

• Psoriasis

• Depression

• Obesity-associated cancers

Understanding the importance of preventive treatment

While more research is needed before GLP-1 receptor agonists are approved for the use of reducing obesity-associated cancer risks directly, reducing insulin resistance, improving insulin sensitivity, and lowering chronic inflammation is important for preventive health. 

If you currently struggle with excess weight and/or insulin resistance, start by making lifestyle changes, including following a healthy diet, getting regular exercise, and ensuring adequate sleep. If you are considering treatment with a GLP-1s for weight loss, check out Agile’s weight loss program! 

If you qualify for the program, you’ll speak to one of our licensed providers in a no-cost consultation to determine if the treatment is right for you. 

Ready to make a change? See if you qualify here!