GLP-1 Colorectal Cancer Risk Significantly Lower Than Aspirin: 2026 ASCO GI Study Findings
A major real-world study presented at the 2026 American Society of Clinical Oncology (ASCO) Gastrointestinal Cancers Symposium shows that GLP-1 receptor agonists are associated with a substantially lower risk of colorectal cancer (CRC) compared to aspirin for primary prevention. Patients previously exposed to GLP-1 drugs had markedly reduced CRC incidence, along with a superior safety profile—particularly fewer bleeding events—highlighting potential advantages in addressing GLP-1 colorectal cancer prevention.
Study Design and Main Results on GLP-1 Colorectal Cancer Prevention
Led by Colton Frisco Jones, MD (University of Texas at San Antonio), the retrospective analysis used TriNetX data (>150 million patients). It included 149,115 with GLP-1 exposure and over 3 million with aspirin, propensity-matched to 140,828 per group (median age 58, ~6-year follow-up for GLP-1 vs ~5 for aspirin).
Key findings for GLP-1 colorectal cancer risk:
- 36% lower CRC odds overall (HR 0.643, 95% CI 0.531-0.778).
- 42% reduction in high-risk subgroups (HR 0.579).
- Consistent across age, BMI, diabetes, and specific GLP-1 agents (strongest with liraglutide).
Safety Advantages in GLP-1 vs Aspirin for Colorectal Cancer Prevention
GLP-1 agonists showed better tolerability regarding bleeding:
- GI bleeding: HR 0.852 (P=0.018).
- Gastric ulcers: HR 0.815 (P=0.038).
- Acute kidney injury: HR 0.369.
Higher GI side effects (diarrhea, abdominal pain) occurred with GLP-1s, but overall profile favored them over aspirin's bleeding concerns.
Implications for GLP-1 Colorectal Cancer Risk Reduction
Obesity and metabolic issues elevate CRC risk; GLP-1 agonists mitigate via weight loss, insulin sensitivity, and anti-inflammatory effects. Presenter Jones noted the findings warrant randomized trials, as this real-world head-to-head is among the first for primary prevention.
Evidence Overview
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