Weight loss interventions and obesity‐associated cancers in people with type 2 diabetes and overweight/obesity: A real‐world observational study
Authors' conclusion
Semaglutide and BS were associated with lower cancer rates in individuals with overweight/obesity and T2D, with non-significant lower rates also observed with tirzepatide. These findings suggest weight-loss interventions may contribute to cancer prevention in this population.
Study context
- Population
- Adults with overweight/obesity and T2D treated June 2005–June 20253 matched cohorts
- Exposure
- Semaglutide, tirzepatide or bariatric surgery (BS) vs DPP-4i
- Semaglutiden = 64,178
- Tirzepatiden = 19,682
- BSn = 9,642
- Outcome
- Composite and individual obesity-associated cancers (OAC): breast, colorectal, gallbladder, liver, multiple myeloma, oesophageal, ovarian, pancreatic, renal, gastric cardia, thyroid and uterine
Methodological detailsTriNetX federated research network, propensity score matched (1:1), Cox regression
- TriNetX federated research network
- Propensity score matched (1:1)
- Cox regression
Main finding
As reported in the abstract
Composite OAC
Each group vs DPP-4iHazard ratio (95% CI)
Semaglutide64,178 matched pairs; mean follow-up 911 days
0.88(0.82–0.95)
Tirzepatide19,682 matched pairs; mean follow-up 435 days; non-significant
0.84(0.69–1.01)
BS9642 matched pairs; mean follow-up 1746 days
0.85(0.74–0.98)
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | |
|---|---|---|
| Individual OAC with semaglutideSemaglutidevs DPP-4iColorectal cancer | 0.80 (0.67–0.97) | |
| Individual OAC with semaglutideSemaglutidevs DPP-4iLiver cancer | 0.75 (0.60–0.95) | |
| Individual OAC with semaglutideSemaglutidevs DPP-4iPancreatic cancer | 0.76 (0.60–0.96) | |
| Ovarian cancer with tirzepatideTirzepatidevs DPP-4iSignificant lower rate | 0.31 (0.10–0.95) | |
| Individual OAC with BSBSvs DPP-4iLiver cancer | 0.56 (0.32–0.97) | |
| Individual OAC with BSBSvs DPP-4iUterine cancer | 0.59 (0.38–0.90) | |
| Individual OAC with BSBSvs DPP-4iGastric cardia cancer; higher rate | 10.54 (1.35–82.38) | |
| Individual OAC with BSBSvs DPP-4iOesophageal cancer; higher rate | 4.78 (1.04–21.87) | |
| 0.050.21520Hazard ratio (log scale) |
Original publication
Weight loss interventions and obesity‐associated cancers in people with type 2 diabetes and overweight/obesity: A real‐world observational study. Diabetes Obes Metab. Published 3 September 2025. doi:10.
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