Treating Obesity as a Risk Reduction Strategy for Cancer

For the second time in the past few months, a signal from the surveillance of GLP-1 agonists is surfacing to suggest that these drugs may offer a risk reduction strategy for cancer.

Earlier, the signal came from a study of persons receiving treatment for diabetes. The present study, presented at the recent annual meeting for the American Society of Clinical Oncology, focused on people with moderate or severe obesity receiving these drugs. Cindy (Hsin-Ti) Lin and colleagues found a 39% reduction in risk of obesity-related cancers in people receiving GLP-1 agonists compared to those receiving neither these drugs nor bariatric surgery. Arif Kamal, Chief Patient Officer at the American Cancer Society, described these results as impressive:

“I think a 39% risk reduction is one of the most impactful risk reductions we’ve ever really seen.”

Observational Study of 34,342 Patients

This is observational research involving 15 years of medical records for 34,342 patients. So it is not the final word on the effectiveness of GLP-1 agonists for cancer risk reduction. Rather, it provides a signal that use of these medicines in people with obesity is associated with a lower risk of cancers related to obesity.

These researchers were careful to make three pair-wise propensity-score matched comparisons in finding this risk reduction. They also found a reduction by half in risk of death with GLP-1s and a 22% reduction in cancers with bariatric surgery.

But at the end of the day, we must remember that residual confounding is still a possibility. More research will be necessary to gain confidence that these medicines can indeed reduce the risk of obesity-related cancers.

Slowly Debunking a False Dichotomy

We have long heard the reiteration of a now tired and false dichotomy. It pits obesity treatment against prevention. But these findings add to the evidence of just how flawed that dichotomy is.

The goal of prevention is to avoid future health problems. Granting that it might be nice to prevent people from ever suffering with obesity, the fact is that nearly half the population already does. Another quarter of the population lives in the range of overweight.

So if we truly believe in prevention, the growing evidence that treating obesity can prevent future health problems – with cancer, heart attacks, strokes, heart failure, sleep apnea, kidney, and liver disease – is surely good news.

Yes, it is becoming apparent that obesity treatment is good preventive care for health.

Click here for the study abstract from the ASCO meeting, here and here for further reporting on it.

Fishing in the Shadow of Grave Risks, photograph by Michael Angelo Luna, licensed under CC BY-SA 4.0

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August 13, 2024