Dong Jiawen, Starkey Thomas, Cheng Vinton W T, Clark James, Pinato David J, Robinson Timothy, Tilby Michael, Turnbull Christopher D, Yw Lee Lennard
Oxford Centre for Diabetes, Endocrinology & Metabolism, Churchill Hospital, University of Oxford, Headington, Oxford OX3 7LE, United Kingdom; Oxford University Hospitals NHS Foundation Trust, Headley Way, Headington, Oxford OX3 9DU.
Department of Pharmacology and Therapeutics, University of Liverpool, Liverpool L69 3GE, United Kingdom.
Cancer Epidemiol. 2025 Aug;97:102837. doi: 10.1016/j.canep.2025.102837. Epub 2025 May 24.
Obesity is a major risk factor for many cancers. Glucagon-like peptide-1 receptor agonists (GLP-1RA) have emerged as highly effective agents for weight loss. There is a lack of published modelling studies describing the broader implications of GLP-1RA-induced weight loss on cancer incidence.
A Markov state-transition model was devised to evaluate the impact of GLP-1RA-induced weight loss on future cancer incidence in adults. Contemporary data on weight distribution, cancer incidence, and body mass index (BMI)-associated cancer risk were integrated into the model. Two scenarios were assessed, GLP-1RAs were made available to all people with obesity (BMI>30) or only those with severe obesity (BMI>35). New cancer cases were simulated over a decade.
Our simulation within a closed cohort indicated that GLP-1RA-induced weight loss would lead to a marked decrease in cancer cases over 10 years in adults. If GLP-1RAs were made available for all people with obesity and 50 % of people with obesity moved into a lower BMI category, there was a simulated reduction in cumulative cancer cases of 21,443. If access to GLP-1RAs was restricted to people with severe obesity and 50 % of people with severe obesity moved into a lower BMI category, there was a simulated reduction in cumulative cancer cases of 7476. This effect was greatest for uterine, kidney, liver and colon cancer.
Targeted weight control measures using GLP-1RAs could reduce new cancer cases. Based on our models, the potential risk of thyroid cancer is balanced by a reduction in other cancer types. This modelling study shows for the first time that implementing effective weight loss programmes could enhance the health of the population over the next decade through a reduction in cancer cases.
肥胖是多种癌症的主要风险因素。胰高血糖素样肽-1受体激动剂（GLP-1RA）已成为高效的减肥药物。目前缺乏已发表的模型研究来描述GLP-1RA诱导的体重减轻对癌症发病率的更广泛影响。
设计了一个马尔可夫状态转换模型，以评估GLP-1RA诱导的体重减轻对成人未来癌症发病率的影响。将有关体重分布、癌症发病率和体重指数（BMI）相关癌症风险的当代数据纳入该模型。评估了两种情况，即向所有肥胖者（BMI>30）或仅向重度肥胖者（BMI>35）提供GLP-1RA。模拟了十年内的新癌症病例。
我们在一个封闭队列中的模拟表明，GLP-1RA诱导的体重减轻将导致成人在10年内癌症病例显著减少。如果向所有肥胖者提供GLP-1RA，且50%的肥胖者体重指数降至较低类别，则模拟的累积癌症病例减少21443例。如果仅向重度肥胖者提供GLP-1RA，且50%的重度肥胖者体重指数降至较低类别，则模拟的累积癌症病例减少7476例。这种效果在子宫癌、肾癌、肝癌和结肠癌中最为明显。
使用GLP-1RA进行有针对性的体重控制措施可减少新的癌症病例。根据我们的模型，甲状腺癌的潜在风险被其他癌症类型的减少所平衡。这项模型研究首次表明，实施有效的减肥计划可在未来十年通过减少癌症病例来改善人群健康。
