Risk of neoplasms with semaglutide in patients with type 2 diabetes: a systematic review and meta-analysis of randomized controlled trials
In brief
Semaglutide raises overall tumor risk by about 20% in type 2 diabetes
A meta-analysis of 19 randomized trials involving 38,160 patients found that semaglutide use was linked to a 19% higher odds of any neoplasm and a 28% higher odds of benign tumors, while the increase in malignant cancers did not reach statistical significance. Clinicians should stay alert to these modest risks, and longer trials are needed to determine their true clinical impact.
- Journal
- Frontiers in pharmacology (Q1)
- Published
- 3 September 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Yuanyuan Zhong, Xing Tan, Ling Zhang, Cangui Wu
- PMID
- 42757217
- DOI
- 10.3389/fphar.2026.1916932
Why clinicians should know about it
- Picked for Pharmacology (medical) (top studies of the week, 20 September 2026): Semaglutide modestly raises overall and benign neoplasm risk
Abstract
BACKGROUND: Semaglutide is prescribed in conjunction with diet and exercise to improve glycemic control in adults with type 2 diabetes (T2DM). However, its potential impact on tumorigenesis has prompted considerable debate. METHODS: The meta-analysis was conducted in accordance with PRISMA 2020 guidelines. We searched Web of Science, PubMed, Embase, and ScienceDirect for eligible randomized controlled trials (RCTs). The outcome was the risk of overall, benign and malignant neoplasms. The pooled results were expressed as odds ratio (OR) with 95% confidence interval (95% CI). Influential publication was determined by performing the sensitivity analysis. Publication bias was assessed using the funnel plot, Begg's and Egger's tests. RESULTS: Nineteen RCTs conducted between 2016 and 2025 were included, enrolling of 38,160 patients with T2DM. The interventions involved subcutaneous semaglutide and oral semaglutide, with treatment durations ranging from 26 to 156 weeks. Fixed-effects meta-analysis revealed that semaglutide use was associated with an increased risk of overall neoplasms (OR = 1.19, 95% CI = 1.07 to 1.32, P = 0.001) and benign neoplasms (OR = 1.28, 95% CI = 1.02 to 1.61, P = 0.032), but showed no significant association with malignant neoplasms (OR = 1.12, 95% CI = 1.00 to 1.26, P = 0.054). No influential publications or significant publication bias were detected. CONCLUSION: Semaglutide use in patients with T2DM is associated with a modestly increased risk of overall and benign neoplasms, but not malignant neoplasms. These findings highlight the importance of maintaining clinical awareness regarding potential neoplastic risks, and further long-term RCTs are warranted to clarify their clinical significance. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261354386, Identifier CRD420261354386.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.