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. 2025 Aug:97:102837.
doi: 10.1016/j.canep.2025.102837. Epub 2025 May 24.

Impact of GLP-1 receptor agonist-induced weight loss on 22 cancers in the next ten years using a Markov state-transition model - A UK weight and wellness cancer landscape analysis

Jiawen Dong  1 , Thomas Starkey  2 , Vinton W T Cheng  3 , James Clark  4 , David J Pinato  5 , Timothy Robinson  6 , Michael Tilby  7 , Christopher D Turnbull  8 , Lennard Yw Lee  9 ; UK weight and wellness research consortium
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Free article

Impact of GLP-1 receptor agonist-induced weight loss on 22 cancers in the next ten years using a Markov state-transition model - A UK weight and wellness cancer landscape analysis

Jiawen Dong et al. Cancer Epidemiol. 2025 Aug.
Free article

Abstract

Background: Obesity is a major risk factor for many cancers. Glucagon-like peptide-1 receptor agonists (GLP-1RA) have emerged as highly effective agents for weight loss. There is a lack of published modelling studies describing the broader implications of GLP-1RA-induced weight loss on cancer incidence.

Methods: A Markov state-transition model was devised to evaluate the impact of GLP-1RA-induced weight loss on future cancer incidence in adults. Contemporary data on weight distribution, cancer incidence, and body mass index (BMI)-associated cancer risk were integrated into the model. Two scenarios were assessed, GLP-1RAs were made available to all people with obesity (BMI>30) or only those with severe obesity (BMI>35). New cancer cases were simulated over a decade.

Results: Our simulation within a closed cohort indicated that GLP-1RA-induced weight loss would lead to a marked decrease in cancer cases over 10 years in adults. If GLP-1RAs were made available for all people with obesity and 50 % of people with obesity moved into a lower BMI category, there was a simulated reduction in cumulative cancer cases of 21,443. If access to GLP-1RAs was restricted to people with severe obesity and 50 % of people with severe obesity moved into a lower BMI category, there was a simulated reduction in cumulative cancer cases of 7476. This effect was greatest for uterine, kidney, liver and colon cancer.

Conclusion: Targeted weight control measures using GLP-1RAs could reduce new cancer cases. Based on our models, the potential risk of thyroid cancer is balanced by a reduction in other cancer types. This modelling study shows for the first time that implementing effective weight loss programmes could enhance the health of the population over the next decade through a reduction in cancer cases.

Keywords: Cancer; GLP agonist; GLP-1 agonist; Glucagon-like peptide 1; Incidence; Model; Modelling; State transition; Weight loss.

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Conflict of interest statement

Declaration of competing interest TR has received travel support from Novartis, MSD, Daiichi-Sankyo; speaker fees from Novartis; institutional grant funding from Debiopharm, Gilead; direct funding from MedSIR and is a clinical expert on the NICE Breast Cancer Guidelines committee. CT has done consulting work for Eli Lilly.

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