Use of Glucagon-Like Peptide-1 Receptor Agonists Does Not Increase the Risk of Cancer in Patients with Type 2 Diabetes Mellitus

Oct 23, 2024Diabetes & metabolism journal

Glucagon-Like Peptide-1 Receptor Agonists are Not Linked to Higher Cancer Risk in People with Type 2 Diabetes

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Abstract

Patients with type 2 diabetes mellitus (T2DM) have a 73% higher risk of cancer compared to the general population.

The incidence rate ratio (IRR) for subsequent cancer in patients with T2DM was 1.73, indicating a higher risk compared to individuals without diabetes.
No increased cancer risk was observed in patients with T2DM using glucagon-like peptide-1 receptor agonists (GLP-1 RAs).
The IRR for pancreatic cancer in the GLP-1 RA group was 0.74, suggesting no significant increase in risk.
Thyroid cancer risk showed an IRR of 1.32 in the GLP-1 RA group, which did not indicate a significant increase.
Medullary thyroid cancer risk was lower in the GLP-1 RA group, with an IRR of 0.34.

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BACKGRUOUND: Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for the treatment of type 2 diabetes mellitus (T2DM) given their extra-pancreatic effects. However, there are concerns about carcinogenesis in the pancreas and thyroid gland. We aimed to evaluate the site-specific incidence of cancer in patients with T2DM-treated GLP-1 RAs using a nationwide cohort.

METHODS: This study included data obtained from the Korean National Health Insurance Service (between 2004 and 2021). The primary outcome was newly diagnosed cancer, and the median follow-up duration for all participants was 8 years.

RESULTS: After propensity score matching, 7,827 participants were analyzed; 2,609 individuals each were included in the GLP-1 RA, diabetes mellitus (DM) control, and non-DM control groups. The incidence rate ratio (IRR) of subsequent cancer in patients with T2DM was 1.73, which was higher than that of individuals without DM, and it increased in both men and women. Analysis of patients with T2DM showed no increased cancer risk associated with the use of GLP-1 RA, and similar results were observed in both men and women. The IRRs of pancreatic cancer (0.74), thyroid cancer (1.32), and medullary thyroid cancer (0.34) did not significantly increase in the GLP-1 RA group compared with those in the DM control group.

CONCLUSION: There was a 73% higher risk of cancer in patients with T2DM compared with the general population. However, among patients with T2DM, there was no association between the use of GLP-1 RAs and new-onset cancers, including pancreatic and medullary thyroid cancers.

Key numbers

1.73

Cancer Risk Increase

Incidence rate ratio of cancer in T2DM vs. non-DM individuals

0.94

No Increased Cancer Risk

Incidence rate ratio for cancer in GLP-1 RA users vs. DM control

0.74

Pancreatic Cancer Risk

Incidence rate ratio for pancreatic cancer in GLP-1 RA users vs. DM control

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Use of Glucagon-Like Peptide-1 Receptor Agonists Does Not Increase the Risk of Cancer in Patients with Type 2 Diabetes Mellitus

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