Introduction:
Obesity and diabetes increase the risk of certain malignancies termed obesity-related cancers (ORC). Both GLP-1 receptor agonists (GLP-1 RAs) and bariatric metabolic surgery (BMS) are known to reduce weight and improve metabolic health, but their comparative effectiveness in ORC prevention is not well studied.
Objective:
To compare the incidence of ORC in adults with obesity and diabetes treated with first-generation GLP-1 RAs versus BMS.
Methods:
- Design: Retrospective, observational cohort study
- Study Population:
- Adults ≥24 years with obesity and diabetes
- No prior history of ORC
- Treated with GLP-1 RA or BMS between 2008–2018
- Matching: 3,440 matched pairs (n = 6,880) based on age, sex, baseline BMI, smoking, and treatment initiation time
- Primary Outcome: Incidence of ORC (including 14 specific cancers)
Results:
|
Measure |
GLP-1 RA |
BMS |
|
ORC incidence rate (per 1,000 person-years) |
6.64 |
6.70 |
|
Adjusted HR (GLP-1 RA vs BMS) |
1.01 (95% CI: 0.83–1.25) |
— |
|
Adjusted OR (accounting for weight loss) |
0.73 (95% CI: 0.56–0.95) |
— |
Conclusion:
While BMS and GLP-1 RAs showed similar crude ORC incidence rates, adjusting for weight loss revealed that GLP-1 RAs had a stronger protective effect against obesity-related cancers. These findings suggest that GLP-1 RAs may offer cancer-preventive benefits beyond weight reduction, and newer, more potent GLP-1 RAs could offer even greater protection.
ECO, 11-14 May 2025, Malaga, Spain
