What You Need to Know About Ozempic and its Effect on Colorectal Cancer Risk

A recent study reveals that certain anti-obesity medications may also help decrease the risk of colorectal cancer.

Specially, GLP-1 receptor agonist drugs (GLP-1 RAs), which are commonly used to address obesity and type 2 diabetes, can potentially decrease the risk of colorectal cancer (CRC).

The research, published in JAMA Oncology, evaluated electronic health records of more than 1.2 million patients who received antidiabetic drugs from 2005 to 2019.

The scientists studied the impact of GLP-1 RAs on CRC incidence, in comparison to patients prescribed different antidiabetic medications. They concluded that GLP-1 RAs, including Ozempic, led to lower CRC rates.

The link between these medications and lower CRC risk may be attributed to their effectiveness against obesity, but this relationship requires further examination and consideration.

The likelihood of developing CRC and worsening its prognosis is greater for those overweight, obese, or with type 2 diabetes. One reason behind this increased risk is high glucose and insulin levels in diabetic patients, which can stimulate tumor growth, according to Cedrek McFadden, MD, a member of the Colorectal Cancer Alliance medical scientific advisory committee.

Patients with diabetes or obesity are more likely to die from CRC. However, the weight loss attributable to GLP-1 RAs is likely not the only contributing factor in reducing CRC risk, added Nathan Berger, MD, professor of experimental medicine at the Case Western Reserve School of Medicine and a co-researcher of the study.

“Our study focused on cancer prevention, not the underlying mechanism. However, GLP-1 RAs significantly reduced CRC incidence in all patients, regardless of their weight classification." said Nathan Berger, MD.

For a deeper understanding of the relationship between GLP-1 RAs and cancer risks and progression, more extensive, long-term clinical trials are needed, explained McFadden.

CRC, the second leading cause of cancer death in the U.S., is projected to be diagnosed in about 153,020 individuals this year by the Colorectal Cancer Alliance. The median diagnosis age for both men and women is 66 years old, although rates have risen by 2.2% annually from 2007 to 2016 for individuals under 50.

African-Americans have the second highest incidence and mortality rates of CRC. They have a 20% greater incidence and a 35% increased mortality rate from CRC.

McFadden suggests the disparities in the African-American community are tied to genetic factors, aggressive tumor biology, lower screening rates, and socioeconomic disparities.

People can utilize a variety of tests to screen for CRC, such as FIT, colonoscopy, and Cologuard. Genetic testing is often recommended for those with a strong familial history of CRC or specific genetic syndromes to assess inherited risk factors, McFadden states.

“Despite family history, any strange symptoms or issues related to the digestive system should be reported, like changes in bowel habits, bloody stool, abdominal pain, or unplanned weight loss." he added.

Regular screenings play a vital role in CRC prevention. In fact, CRC is one of the most preventable cancers if appropriate screening is carried out.

Screening usually starts at age 45 with a colonoscopy. Yet, if CRC or polyps has been diagnosed in the family, screening should start ten years before the family member's diagnosis. Regardless of age, a colonoscopy is recommended if symptoms related to CRC such as rectal bleeding, changes in bowel habits, abdominal pain, fatigue, or unexplained weight loss are experienced, stated McFadden.

The Colorectal Cancer Alliance has initiated a Health Equity Fund to decrease disparities regarding screening and treatment for those disproportionately affected by the disease, and improve outcomes for those facing obstacles to quality care.

The Fund provides free colonoscopies for Black Americans, free online screening quizzes, financial assistance for non-medical expenses related to CRC screening and treatment, and more. 

“If colorectal cancer is diagnosed, doctors will help with understanding the stage of the cancer and explore appropriate treatment options that may involve surgery, chemotherapy, radiation therapy, or a combination of these,” said McFadden.

In complex cases, or when faced with difficult treatment decisions, McFadden explained that seeking a second opinion from another qualified healthcare professional can provide additional perspectives and insights.