A recent retrospective analysis of electronic health records has suggested that GLP-1 receptor agonists may lower the risk of several obesity-associated cancers in individuals with type II diabetes. This study, conducted by Nathan Berger, MD, of Case Western Reserve University along with his colleagues and published in JAMA Network Open, found that compared to insulin, GLP-1s were associated with a lower risk of developing 10 out of 13 cancers over a follow-up period of up to 15 years.
The analysis revealed significant risk reductions in various types of cancer with the use of GLP-1 receptor agonists. These include gallbladder cancer, meningioma, pancreatic cancer, hepatocellular carcinoma, ovarian cancer, colorectal cancer, multiple myeloma, esophageal cancer, endometrial cancer, and kidney cancer. However, it is important to note that no decrease in cancer risk was observed with GLP-1 receptors compared to metformin.
Co-author and medical student Lindsey Wang emphasized the importance of this study in contributing to the existing body of evidence on the potential cancer prevention effects of GLP-1 receptor agonists, particularly in relation to obesity-associated cancers. The study also highlighted the significance of newer GLP-1 receptor agonists such as semaglutide and tirzepatide, which are increasingly being used for both type 2 diabetes management and weight loss.
When compared to insulin, GLP-1s showed a trend towards reducing the risk of stomach cancer, although this trend did not reach statistical significance. Additionally, GLP-1s were not associated with a lower risk of postmenopausal breast cancer or thyroid cancer. On the other hand, when compared to metformin, there was a nonsignificant trend towards a reduced risk of colorectal and gallbladder cancer. However, GLP-1 treatment was linked to an increased risk of kidney cancer relative to metformin.
The findings of this study underscore the need for continued monitoring of patients being treated with GLP-1 receptor agonists, particularly in relation to the increased risk of kidney cancer. While GLP-1s have direct effects on kidney function in renal vasculature, previous reports have not linked them with increased mitogenesis or kidney cancers. Nevertheless, the researchers highlighted the importance of ongoing surveillance in this population.
The analysis was based on electronic health records from 1,651,452 U.S. patients with type 2 diabetes who were prescribed GLP-1 receptor agonists, insulins, or metformin between 2005 and 2018. Patients included in the study did not have a prior diagnosis of obesity-associated cancers. The average age of participants was approximately 59.8 years, with a majority being white and male. The study population also exhibited various differences in demographics, medical history, and prior medication use between GLP-1 users and insulin users.
It is important to note that the results of this analysis may not be generalizable to other populations, as patients included had medical encounters with a specific healthcare system. The study did not control for healthcare utilization or insurance type, which could be potential confounders in the analysis. While the study provides valuable insights into the potential benefits of GLP-1 receptor agonists in reducing the risk of obesity-associated cancers, further research is needed to confirm these findings and address existing limitations.
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