SAN ANTONIO, February 29, 2026 — A common class of diabetes drugs appears to offer a surprising benefit: a significantly lower risk of colorectal cancer compared to aspirin, according to research unveiled at the ASCO Gastrointestinal Cancers Symposium 2026. This finding suggests a potential shift in preventative strategies for this common cancer.
GLP-1s vs. Aspirin: A New Approach to Cancer Prevention?
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A large study reveals GLP-1 receptor antagonist therapy may reduce colorectal cancer incidence by 36% compared to aspirin.
- GLP-1RA therapy was associated with a 36% lower incidence of colorectal cancer (CRC) compared to aspirin.
- The benefit was even more pronounced in patients considered at high risk for CRC.
- GLP-1RAs demonstrated a more favorable safety profile than aspirin, with lower rates of gastrointestinal bleeding and acute kidney injury.
- The protective effect was observed regardless of whether patients had diabetes or which specific GLP-1RA medication they used.
“The large population size of this study and the favorable safety profile of GLP-1s versus aspirin could underscore a potential public health impact, and these findings warrant prospective validation,” said study presenter Colton Jones, MD of The University of Texas Health Science Center in San Antonio. The research offers a compelling alternative to aspirin for those seeking to lower their CRC risk.
Real-World Data from a Massive Database
Researchers analyzed deidentified data from the TriNetX database, encompassing records from approximately 150 million patients across 106 health systems. The study period spanned from January 1, 2000, to January 1, 2024. To ensure a fair comparison, they used a technique called propensity score matching to create comparable groups of patients taking GLP-1RA therapy and aspirin.
Patients with existing colorectal cancer, those using other NSAIDs besides aspirin, or those taking hypoglycemic medications other than GLP-1RAs were excluded from the analysis, as were deceased patients. This left a study group of 149,115 GLP-1RA users and 3,011,724 aspirin users, which were then matched to include 140,828 patients in each cohort. The average age of patients at the start of the study was 58 ± 13.5 years in the GLP-1RA group and 58 ± 13.7 years in the aspirin group. Both groups were predominantly female (67%) and White (67%), with 12% identifying as Black and 2.3% as Asian.
Significant Reduction in Cancer Incidence
Overall, the incidence of colorectal cancer was approximately 36% lower in the GLP-1RA group compared to the aspirin group (hazard ratio [HR] 0.643; 95% CI, 0.531-0.778). This protective effect was even more substantial in patients deemed to be at high risk for the disease (HR, 0.579; 95% CI, 0.401-0.837).
What’s the best way to reduce your risk of colorectal cancer? This study suggests that GLP-1RA therapy may be more effective than aspirin, particularly for individuals at higher risk.
The benefit of GLP-1RAs extended to both patients with and without diabetes. For those with diabetes, the hazard ratio for CRC incidence was 0.746 (95% CI, 0.511-0.982). For patients without diabetes, the hazard ratio was 0.588 (95% CI, 0.471-0.734). Importantly, the researchers found that the lower CRC incidence held true regardless of which GLP-1RA medication patients used – semaglutide, liraglutide, or dulaglutide.
Safety Considerations: A Favorable Profile
While both treatments have potential side effects, GLP-1RAs appeared to have a more favorable safety profile. Gastrointestinal bleeding occurred in 2% of GLP-1RA users and 2.1% of aspirin users (HR, 0.852; 95% CI, 0.809-0.898; P =.018). Gastric ulcers were also less common with GLP-1RAs (0.5% vs. 0.55%; HR, 0.815; 95% CI, 0.735-0.904; P =.038), as was acute kidney injury (1.15% vs. 2.8%; HR, 0.369; 95% CI, 0.348-0.391; P =.0001).
However, diarrhea (HR, 1.131; 95% CI, 1.096-1.166; P =.0001) and abdominal pain (HR, 1.055; 95% CI, 1.036-1.075; P =.0001) were reported more frequently with GLP-1RA use.
“So in conclusion, in this real-world, head-to-head comparison of GLP-1 use versus aspirin, GLP-1 users were associated with a 36% reduction in colorectal cancer incidence, and this reduction was even greater in patients who had high-risk features,” Dr. Jones stated during his presentation. Disclosures: There was no funding listed for this study. One study author disclosed conflicts of interest. Please see the original reference for complete disclosures.
