A large retrospective cohort study found that GLP-1 receptor agonist use was associated with significantly lower 5-year rates of colorectal cancer among patients with inflammatory bowel disease (IBD). The research was highlighted in a media briefing ahead of the 2026 ASCO Breakthrough Meeting, taking place June 25 to June 27 in Singapore.
IBD, including Crohn’s disease and ulcerative colitis, is a known risk factor for colorectal cancer. The study used TriNetX, a health-care database of more than 150 million people in the United States, to evaluate whether GLP-1 receptor agonist use was associated with colorectal cancer incidence among patients with IBD, including a subgroup with both IBD and type 2 diabetes.
“Patients with inflammatory bowel disease and both inflammatory bowel disease and type 2 diabetes represent particularly high-risk populations for colorectal cancer. However, to our knowledge, this population has not been studied at a larger scale,” said lead study author Sarina Ailawadi, DO, of Case Western Reserve University in Cleveland.
Study Details
The researchers identified 1,137,300 patients with IBD, including 70,303 GLP-1 receptor agonist users and 1,066,997 nonusers. After propensity score matching for factors including age, sex, race, tobacco use, alcohol use, hypertension, hyperlipidemia, obesity, IBD subtype, steroid use, immunosuppressive use including biologics, and other type 2 diabetes medications, 69,221 patients were included in the analysis.
The 5-year incidence of colorectal cancer was 0.2% among GLP-1 users vs 0.43% among nonusers, corresponding to a 51% lower odds of colorectal cancer (odds ratio = 0.49; P < .001).
A similar association was seen among patients with both IBD and type 2 diabetes. In this group, investigators identified 209,649 patients, including 38,567 GLP-1 receptor agonist users and 171,082 nonusers. After matching, 37,740 patients were included in the analysis. The 5-year incidence of colorectal cancer was 0.31% among GLP-1 users vs 0.57% among nonusers, corresponding to a 46% lower odds of colorectal cancer (odds ratio = 0.54; P < .001).
The GLP-1 receptor agonists included in the analysis were semaglutide, dulaglutide, tirzepatide, exenatide, liraglutide, and lixisenatide.
The researchers said prospective studies are needed to confirm whether GLP-1 receptor agonists may have a protective effect on colorectal cancer risk in patients with IBD. They also plan to analyze side effects of GLP-1 receptor agonists in this population, because common symptoms such as nausea, vomiting, constipation, abdominal discomfort, and decreased appetite may overlap with symptoms of an IBD flare.
Expert Perspective
“People with inflammatory bowel disease, including Crohn’s disease and ulcerative colitis, are known to have higher risk of developing colorectal cancer. This large population-based study found that people with inflammatory bowel disease who received GLP-1 receptor agonist medications, either for diabetes or other reasons, had a lower incidence of developing colon cancer compared to those who did not receive those medications, said Julie R. Gralow, MD, FACP, FASCO, ASCO Chief Medical Officer and Executive Vice President. “This is promising data that supports the need for further studies evaluating whether GLP-1 receptor agonists can reduce risk in this population at high risk for developing cancer.”
Disclosures: No funding sources were reported. For full disclosures of the study authors, visit coi.asco.org.
