The impact of GLP-1 receptor agonist-induced weight loss on 22 cancers in the next ten years using a markov state-transition model

Jiawen Dong; Thomas Starkey; Vinton Cheng; James Clarke; David Pinato; Timothy Robinson; Michael Tilby; Christopher Turnbull; Lennard Lee

doi:10.1530/endoabs.109.OP2.1

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Endocrine Abstracts (2025) 109 OP2.1 | DOI: 10.1530/endoabs.109.OP2.1

SFEBES2025 Poster Oral Presentations Metabolism, Obesity and Diabetes (4 abstracts)

The impact of GLP-1 receptor agonist-induced weight loss on 22 cancers in the next ten years using a markov state-transition model

Jiawen Dong ^1,2 , Thomas Starkey ³ , Vinton Cheng ⁴ , James Clarke ⁵ , David Pinato ^6,7 , Timothy Robinson ⁸ , Michael Tilby ⁹ , Christopher Turnbull ¹⁰ & Lennard Lee ^10,11

Author affiliations

¹Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom; ²Oxford Centre for Diabetes, Endocrinology & Metabolism, Oxford, United Kingdom; ³University of Liverpool, Liverpool, United Kingdom; ⁴Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom; ⁵Imperial College Healthcare NHS Foundation Trust, London, United Kingdom; ⁶Department of Surgery and Cancer, Hammersmith Hospital Campus, Imperial College London, London, United Kingdom; ⁷Department of Translational Medicine, Division of Oncology, Università Del Piemonte Orientale ‘A. Avogadro‘, Novara, Italy; ⁸University of Bristol, Beacon House, Bristol, United Kingdom; ⁹University Hospitals Coventry & Warwickshire, Coventry, United Kingdom; ¹⁰Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom; ¹¹Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, Birmingham B15 2TT, United Kingdom

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

Methods: A Markov cohort state-transition model was devised to evaluate the impact of GLP-1 receptor agonist (GLP-1RA) -induced weight loss on future cancer incidence. Contemporary data on weight distribution, cancer incidence, and body mass index (BMI)-associated cancer risk were integrated into the model. As an exercise to demonstrate the impact of extensive GLP-1RA uptake in the adult population on future cancer cases, a closed cohort with no mortality was modelled over 10 years. Two scenarios were assessed, GLP-1RAs were made available to all people with obesity (BMI>30) or only those with severe obesity (BMI>35).

Findings: When simulating individuals with obesity (BMI>30) or severe obesity (BMI>35) moving into lower BMI categories from GLP-1RA use, reductions in overall cancer cases were seen. This effect was greatest for uterine, kidney, liver and colon cancer, changing the landscape of new cancer cases over the next decade.

Interpretation: Targeted weight control measures using GLP-1RA could reduce new cancer cases. Based on our models, the potential risk of thyroid cancer is balanced by a reduction in new cases of other cancer types. Although the model has limitations and should not be viewed as a forecast, this study highlights that implementing effective weight loss programmes could enhance the health of the population over the next decade through a reduction in cancer cases.