BACKGROUND: The use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for the treatment of type 2 diabetes and cardiovascular disease risk reduction is increasing. Given the established link between obesity and multiple cancers, there is growing interest in the potential effects of GLP-1RAs on cancer risk reduction.  

OBJECTIVES: This systematic literature review and meta-analysis evaluated the association between GLP-1RA use and cancer incidence. 

METHODS: We conducted literature searches in MEDLINE and EMBASE databases, covering publications up to September 17th, 2025. Our review included studies among adults receiving GLP-1RAs for any indication that reported effects on cancer incidence of any type.  

RESULTS: Among 1,644 unique citations identified, 139 studies met the inclusion criteria for full-text review. After exclusion, a total of 79 observational studies were included in the review and meta-analysis.GLP1-RA use was associated with statistically significant reductions in the incidence of 10 of 13 obesity-associated cancers, specifically colorectal, endometrial, esophageal, gallbladder, liver, ovarian, pancreatic and stomach cancers along with meningioma and multiple myeloma compared to any other T2D medications. Compared to insulin, lower rates of cancer of the colorectum (RR: 0.54, 95% CI; 0.44, 0.66), liver (RR: 0.35, 95% CI; 0.20, 0.62), and pancreas (RR: 0.41, 95% CI; 0.36, 0.48) were observed among patients receiving GLP-1RA. The risk of developing thyroid cancer was elevated among GLP-1RA users (RR: 1.09, 95% CI; 0.98, 1.21).  

CONCLUSIONS: Pooled estimates of observational studies suggest notable reductions in cancer incidence for several obesity-associated cancers. As GLP-1 RA use increases, ongoing safety monitoring and long-term real-world data are essential. The potential role of GLP-1RAs in cancer risk reduction warrants further investigation through large-scale RCTs, alongside balanced risk-benefit discussions with patients.