Diabetes research and clinical practiceOct 27, 2026

Thyroid monitoring during GLP-1 receptor agonist treatment and its possible link to thyroid cancer detection

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Oct 28, 2026

Abstract

Thirty-nine records were included, comprising 29 published studies and 10 registry records, related to thyroid screening in adult GLP-1RA users.

Screening practices for thyroid cancer in GLP-1RA users are varied and primarily focus on biochemical methods.
Calcitonin was reported in 16 out of 29 studies (55.2%) and all registry records, while ultrasonography appeared in 13 out of 29 studies (44.8%).
A screening protocol was described in 19 out of 29 studies (65.5%), but detection bias was addressed in only 11 out of 29 studies (37.9%).
All registry records excluded individuals with personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia type 2 before screening.
The inconsistency in thyroid screening practices and the exclusion of high-risk patients may affect the understanding of thyroid cancer rates among GLP-1RA users.

Simplified

Rodent data prompted a boxed warning for medullary thyroid carcinoma (MTC) with glucagon-like peptide-1 receptor agonists (GLP-1RAs), yet human findings remain inconsistent and may reflect how intensively patients are screened. We mapped reported thyroid screening practices and detection bias reporting. Following JBI methodology and PRISMA-ScR reporting guidance, we searched PubMed, Scopus, Embase, CENTRAL, and ClinicalTrials.gov from 2010 to July 2026. Empirical studies and trial registry records reporting thyroid screening in adult GLP-1RA users were eligible. Records were charted and synthesised descriptively. Thirty-nine records were included (29 published studies, 10 registry records). Screening was predominantly biochemical. Calcitonin was reported in 16/29 studies (55.2%) and all registry records, whereas ultrasonography was reported in 13/29 (44.8%) and no trials. 19/29 studies (65.5%) described a screening protocol. Screening intensity was reported in 18/29 (62.1%) but detection bias in 11/29 (37.9%). All registry records excluded personal or family history of MTC or multiple endocrine neoplasia type 2 before screening. Thyroid screening in GLP-1RA users is heterogeneous, calcitonin-centred, and inconsistently reported, while patients at highest C-cell risk are excluded from trials. Detection bias is seldom addressed despite documented increases in imaging. Standardised reporting of screening intensity is needed to interpret thyroid cancer rates. OSF Protocol Registration Code: 10.17605/OSF.IO/PEBHS.

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Thyroid monitoring during GLP-1 receptor agonist treatment and its possible link to thyroid cancer detection

Abstract

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