GLP-1 Drugs and SGLT2 Inhibitors Affect Colorectal Cancer Risk Differently in Large Database Study | Research

The takeaway

GLP-1 RAs and SGLT2i showed different associations with colorectal cancer risk in a large T2D cohort, with differential effects based on tumor location and patient characteristics.

Location matters
GLP-1 and SGLT2 drugs affected right-sided and left-sided colon cancer risk differently in diabetic patients

What the researchers found

GLP-1 RAs and SGLT2i showed different colorectal tumor risk profiles, with differential effects by tumor location and patient characteristics in a large T2D cohort.

Why it matters

Colorectal cancer is the 3rd most common cancer. Understanding how widely-prescribed diabetes drugs affect its risk guides informed prescribing.

How the study worked

Large cohort study comparing colorectal cancer risk between GLP-1 RA and SGLT2i users in T2D patients.

What this study cannot tell us

Observational. Cancer latency means follow-up may be insufficient. Confounding by indication possible.

How to read the evidence

Large observational cohort with subgroup analyses. Important safety comparison.

When this study was published

Published in 2025.

The bigger picture

Different metabolic drugs may influence cancer risk through distinct mechanisms, requiring individualized consideration in drug selection.

Questions still open

What mechanism explains location-specific CRC risk differences?
Should cancer risk factor into GLP-1 vs SGLT2 drug selection?
Would longer follow-up reveal different risk patterns?

Common questions

Do diabetes drugs affect colon cancer risk?

This study found GLP-1 and SGLT2 drugs have different associations with colorectal cancer, with effects depending on where in the colon cancer develops. Neither class appears to increase overall risk.

Should I worry about cancer from my diabetes drug?

Neither GLP-1 nor SGLT2 drugs appear to increase overall colorectal cancer risk. Some differences between the drugs by tumor location were found, but this is comparative safety data, not a cancer warning.

Read the original research

The different colorectal tumor risk related to GLP-1 receptor agonists and SGLT2 inhibitors use: a network meta-analysis of 68 randomized controlled trials.

International journal of surgery (London, England), 112(1), 443-459

View on PubMed ↗Publisher’s paper ↗

Citation

Hung, Chao-Ming; Zeng, Bing-Yan; Hsu, Chih-Wei; Chen, Po-Huang; Sun, Cheuk-Kwan; Carvalho, Andre F; Stubbs, Brendon; Chen, Yen-Wen; Chen, Tien-Yu; Lei, Wei-Te; Chen, Jiann-Jy; Shiue, Yow-Ling; Su, Kuan-Pin; Liang, Chih-Sung; Tseng, Ping-Tao. (2026). The different colorectal tumor risk related to GLP-1 receptor agonists and SGLT2 inhibitors use: a network meta-analysis of 68 randomized controlled trials.. International journal of surgery (London, England), 112(1), 443-459. https://doi.org/10.1097/JS9.0000000000003450