OTO openJan 12, 2026

Thyroid Cancer Risk in People with Type 2 Diabetes Using Glucagon-Like Peptide-1 Drugs

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Jun 27, 2026

Abstract

Essence

GLP-1 receptor agonist use in type 2 diabetes was not linked to higher 5-year thyroid cancer risk than several common diabetes drugs.

Evidence

This retrospective TriNetX cohort study compared matched patients with type 2 diabetes using GLP-1RAs against SGLT-2 inhibitors, metformin, or DPP-4 inhibitors.

Caveat

The comparisons were observational, confidence intervals crossed no effect, and longer-term risk remains uncertain because many GLP-1RAs were approved within the last decade.

Simplified

OBJECTIVE: Glucagon-like peptide 1 receptor agonists (GLP-1RA) have shown remarkable results in glycemic control for patients with type 2 diabetes (T2DM). While no association has been made, there is a concern for thyroid cancer (TC) from GLP-1RA. We aimed to study the 5-year risk of TC in T2DM patients taking GLP-1RA.

STUDY DESIGN: Retrospective cohort.

SETTING: TriNetX database.

METHODS: TriNetX was queried to identify T2DM patients between 2017 and 2019. The 5-year risk of TC in patients using GLP-1RA was compared to patients taking sodium-glucose cotransporter 2 inhibitors (SGLT-2I), metformin, and dipeptidyl peptidase 4 inhibitors (DPP-4I) after propensity score matching by demographics and comorbidities.

RESULTS: On analysis of T2DM patients taking GLP-1RA compared to SGLT-2I, 7736 patients were in each cohort after matching. The 5-year rate of TC in patients taking GLP-1RA was 0.30% compared to 0.48% in those taking SGLT-2I (RR 0.62 (95% CI 0.37-1.05); = .07). Analysis of GLP-1RA versus metformin yielded 5158 patients in each cohort. Patients taking GLP-1RA had similar rates of TC compared to those taking metformin (0.25% vs 0.39%; RR 0.65 (95% CI 0.32-1.31); = .22). A comparison of GLP-1RA versus DPP-4I yielded 12,570 patients in each cohort. The rate of TC was not increased in those taking GLP-1RA compared to those taking DPP-4I (0.33% vs 0.37%; RR 0.91 (0.60-1.39); = .67). P P P

CONCLUSION: T2DM patients taking GLP-1RA may not have an increased 5-year risk of TC compared to those taking metformin, SGLT-2I, or DPP-4I. Conclusions of long-term use are limited as most GLP-1RA were approved within the last decade.

Key numbers

0.30%

5-Year Rate ()

Rate of in patients taking .

0.48%

5-Year Rate ()

Rate of in patients taking .

0.39%

5-Year Rate (Metformin)

Rate of in patients taking metformin.

Full Text

We can’t show the full text here under this license.

View Full Text ↗

Featured in

GLP-1 TherapiesIssue #20

GLP-1 drugs show promise for kidney transplant patients and Alzheimer's, but may increase eye problems

↗

Thyroid Cancer Risk in People with Type 2 Diabetes Using Glucagon-Like Peptide-1 Drugs

Abstract

Key numbers

Full Text

Featured in

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief

Abstract

Key numbers

Full Text

Related papers

Featured in

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief