New findings suggest that medications used to address obesity, particularly GLP-1 receptor agonist medications like Ozempic, may play a role in lowering the risk of colorectal cancer (CRC), as per a recent study published in JAMA Oncology. Analyzing electronic health records of over 1.2 million patients receiving antidiabetic agents from 2005 to 2019, researchers focused on the impact of GLP-1 RAs on CRC incidence compared to other antidiabetic drugs. The results indicated a 44% reduction in CRC incidence among those treated with GLP-1 RAs compared to insulin-treated patients and a 25% reduction compared to those on Metformin.
Considering the drug class’s effectiveness in combating obesity, it’s essential to weigh the correlation against associated risk factors. Obesity, type 2 diabetes, and being overweight are known contributors to increased CRC incidence and worsened prognosis. Elevated glucose and insulin levels in diabetes patients can promote tumor growth, according to Cedrek McFadden, MD, a member of the Colorectal Cancer Alliance medical scientific advisory committee.
While GLP-1 RAs, such as Ozempic, contribute to weight loss, Nathan Berger, MD, co-lead researcher of the study, suggests that weight reduction may not be the sole factor in CRC risk reduction. The study primarily focused on cancer prevention rather than mechanisms, and GLP-1 RAs significantly reduced CRC incidence in patients with or without overweight and obesity.
To delve deeper into the association between GLP-1 RAs and cancer risks and progression, extensive and prolonged clinical trials are essential, according to McFadden. He emphasizes that the decreased CRC risk observed in GLP-1 users likely stems from factors like weight reduction, improved insulin sensitivity, and adopting a healthier lifestyle, rather than being a direct consequence of the medication itself.
Evaluating the Likelihood of Developing Colorectal Cancer
Colorectal cancer stands as the second leading cause of cancer-related deaths in the United States, with an estimated 153,020 new diagnoses projected by the Colorectal Cancer Alliance this year. While the median age for diagnosis is 66 years for both genders, there has been a notable 2.2% annual increase in rates for individuals under 50 between 2007 and 2016.
African Americans face a higher incidence and mortality rate, experiencing a 20% higher incidence and a 35% elevated risk of colorectal cancer-related death. Cedrek McFadden, a member of the Colorectal Cancer Alliance, attributes these disparities to genetic factors, aggressive tumor biology, lower screening rates, and socioeconomic differences. A lingering stigma associating the disease primarily with older white men may also contribute to a lack of preventive strategies among African Americans.
Various risk factors, including family history, tobacco and alcohol use, age, inflammatory bowel disease, diet, obesity, and previous radiation exposure, are associated with colorectal cancer. Nathan Berger emphasizes the use of comprehensive algorithms to assess CRC risk, particularly heightened by factors like overweight/obesity and diabetes. Screening methods, such as FIT, colonoscopy, and Cologuard, are available. For those with a significant family history or specific genetic syndromes, genetic testing is often recommended to evaluate inherited risk factors. Regardless of family history, prompt reporting of any unusual digestive system symptoms, such as changes in bowel habits, blood in stool, abdominal pain, or unintended weight loss, is crucial for early detection and intervention.
Proactive Screening: The Optimal Defense Against Colorectal Cancer
Regular screenings play a crucial role in the prevention of colorectal cancer, making it one of the most preventable cancers. Screening typically commences at the age of 45 with a colonoscopy. However, if there is a family history of colorectal cancer or polyps, screenings should begin ten years prior to the family member’s diagnosis, as explained by McFadden.
Regardless of age, individuals experiencing symptoms associated with colorectal cancer, such as rectal bleeding, changes in bowel habits, abdominal pain, fatigue, or unexplained weight loss, should undergo a colonoscopy. The Colorectal Cancer Alliance has taken steps to address disparities in screening and treatment through the Health Equity Fund. This initiative aims to enhance outcomes for those disproportionately affected by the disease and facing barriers to quality care.
The Health Equity Fund offers free colonoscopies for Black Americans, online screening quizzes, financial assistance for non-medical expenses related to CRC screening and treatment, among other resources. In the event of a colorectal cancer diagnosis, McFadden emphasizes that doctors will assess the cancer stage and explore appropriate treatment options, which may involve surgery, chemotherapy, radiation therapy, or a combination of these. For complex cases or challenging treatment decisions, seeking a second opinion from another qualified healthcare professional can provide additional perspectives and insights.
