Glucagon-like peptide-1 receptor agonist use and risk of gynecologic cancers: a meta-analysis of multinational real-world cohort studies

Objective Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are widely used for the management of type 2 diabetes mellitus (T2DM) and obesity. Given the established links between metabolic dysfunction and gynecologic malignancies, the potential association between GLP-1RA use and gynecologic cancer risk remains clinically relevant but incompletely defined. We conducted a meta-analysis of real-world cohort studies to evaluate this association. Methods We systematically searched PubMed (from 1966) and Embase (from 1974) through February 15, 2026 for observational cohort studies assessing the association between glucagon-like peptide-1 receptor agonist use and gynecologic cancer outcomes. Hazard ratios (HRs) with 95% confidence intervals (CIs) were pooled using random-effects models. Results Nine retrospective cohort studies were included. GLP-1RA use was not significantly associated with gynecologic cancer risk (HR 0.80; 95% CI: 0.63, 1.01). In cancer subtype analyses, a reduced risk was observed for ovarian cancer (HR 0.68; 95% CI: 0.49, 0.93), whereas associations for endometrial, cervical, and other gynecologic cancers were not statistically significant. Conclusions GLP-1RA use was not significantly associated with overall gynecologic cancer risk, although potential reductions were observed in obesity populations and for ovarian cancer. Given substantial heterogeneity and the observational nature of the evidence, these findings should be interpreted cautiously and considered hypothesis-generating.