GLP-1s More Effective at Preventing Colorectal Cancer Than Aspirin

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) continue to offer promising results in a variety of specialties, including cardiology and obesity, with new results presented during the press briefing for the 2026 American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium offering up a new area of interest for use of this treatment. An abstract set to be presented during the meeting will highlight findings that GLP-1 RAs were able to better prevent colorectal cancer (CRC) compared with aspirin in a real-world analysis.^1,2

CRC is a common type of cancer in the US and is the third-leading cause of cancer-related deaths in men and the fourth-leading in women in the country.³ With the incidence of CRC increasing in young people,⁴ preventing CRC has become more important than ever. Aspirin had been used in the past as a method of chemoprevention, but GLP-1 RAs may have benefits when looking to prevent cancer through inhibiting certain pathways. The study aimed to assess the efficacy of GLP-1 RAs compared with aspirin for primary prevention of CRC.²

The researchers used TriNetX to collect deidentified data from 106 health organizations. Propensity score matching was used to match aspirin users to GLP-1 RA users. The first documented prescription or administration of either the GLP-1 RA or aspirin was used as the index date. Patients used the prescription for 6 months before follow-up began. The incidence of CRC was the primary end point for the study.

There were 281,656 patients who were included in this study, split evenly among GLP-1 RA users and aspirin users. The mean age was 58 years, 69% were women, and 67% were White. The median follow-up for the GLP-1 RA and aspirin user groups was 2153 days and 1743 days, respectively. The incidence of CRC was 0.13% in GLP-1 RA users compared with 0.176% in aspirin users. Those who used GLP-1 RAs had a 26% lower risk of CRC (risk ratio [RR], 0.741), which was found through 12 months (RR, 0.738) and 36 months (RR, 0.779).

All age groups were found to see benefit from using GLP-1 RAs compared with aspirin, with those aged 18 to 44 years (RR, 0.537), aged 45 to 64 years (RR, 0.687), and aged 65 years and older (RR, 0.524) having significant benefits. Body mass index (BMI) was also not found to be detrimental to efficacy, as those with a BMI of less than 29 (RR, 0.520) and 30 or higher (RR, 0.719) saw benefit from using GLP-1 RAs for CRC prevention.

Significant benefit was only found in those who used semaglutide overall (RR, 0.758). Other GLP-1 RAs tested included liraglutide, dulaglutide, tirzepatide, and exenatide.¹ However, there were smaller sample sizes for these other GLP-1 RAs, and further study will be required to assess their efficacy. The researchers also noted that the participants were predominantly White and female, which could have affected the results.

“Because Black men have higher CRC incidence and mortality, further studies are needed to validate these findings. The next steps in our research will involve diverse population studies, inclusive of high-risk patients, to assess generalizability,” Colton Jones, MD, lead author of the study, said in a statement.¹

The researchers concluded that this new finding on GLP-1 RAs’ association with lower CRC risk could make a sizable impact in public health and allow for new avenues to reduce the incidence of CRC in all populations.²

References

1. GLP-1 receptor agonists show potential relative reduction in CRC incidence compared with aspirin. ASCO Daily News. January 5, 2026. Accessed January 6, 2026. https://dailynews.ascopubs.org/do/glp-1-receptor-agonists-show-potential-relative-reduction-crc-incidence-compared
2. Jones C, Obomanu E, Neely A, et al. GLP-1 receptor agonist vs aspirin for primary prevention of colorectal cancer: evidence from a real-world head-to-head comparison. Presented at: ASCO Gastrointestinal Cancers Symposium; January 8-10, 2026. Abstract 18.
3. Key statistics for colorectal cancer. American Cancer Society. Updated April 28, 2025. Accessed January 6, 2026. https://www.cancer.org/cancer/types/colon-rectal-cancer/about/key-statistics.html
4. Phillips C. As rates of some cancer increase in younger people, researchers search for answers. National Cancer Institute. May 14, 2025. Accessed January 6, 2026. https://www.cancer.gov/news-events/cancer-currents-blog/2025/early-onset-cancer-research-environment-genetics-support