In a retrospective study, patients with prior use of GLP-1 receptor agonists showed a significantly lower risk of developing colorectal cancer compared with those who used aspirin. GLP-1 agonist therapy was associated with a 36% reduction in CRC risk overall, which increased to 42% among high-risk individuals. This protective association was consistent across all prespecified subgroups, including age, BMI, presence of atherosclerosis or diabetes, and across different GLP-1 receptor agonists. This was presented as an abstract by Gokul K at ASCO.
The aim of this study was to assess whether the use of GLP-1 receptor agonist and colon cancer risk in type 2 diabetic patients, both in and out of obesity condition, could be inferred by a big database study. This is an observational retrospective study realized in the framework of the international research database named TriNetX. Two cohorts of patients with diagnosed type 2 diabetes and no history of colon cancer were built by this study using propensity score matching criteria. The first cohort consists of patients taking insulin but never exposed to GLP-1 receptor agonists before; the other cohort is composed by first users of GLP-1 receptor agonists.
A total of 965,333 patients were enrolled after matching, giving two very similar groups for comparison. The main outcome measure was incidence of newly diagnosed colon cancer, as identified by using International Classification of Disease, version 10, codes for disease diagnosis. The measures used were risk ratios, odds ratios, and survival curves based on Kaplan-Meier survival analysis, using hazard ratios to compare results, and p < 0.05 defined each measure as statistically significant.
Key findings:
Patients not treated with GLP-1 receptor agonists showed a significantly higher risk of colon cancer.
The risk ratio of colon cancer was 3.06 (95% CI: 2.921–3.207). Also, the odds ratio was 3.08 (95% CI: 2.935–3.223).
Time-to-event analysis showed a hazard ratio of 2.702 (95% CI: 2.578–2.833).
All associations are highly statistically significant at p < 0.0001.
The absolute difference in risk between the two cohorts is 0.498% (95% CI: 0.478%–0.517%).
GLP-1 receptor agonists were associated with a significantly decreased risk of colon cancer and mortality compared with insulin in diabetic patients with type 2 diabetes. This large-scale population study lends credence to a protective effect of GLP-1 receptor agonists against colon malignancy and emphasizes a need for further long-term and investigative research to clearly authenticate these anticancer effects.
Reference:
Do glucagon-like peptide 1 receptor agonists offer protective effect on colon cancer risk? - ASCO. https://www.asco.org/abstracts-presentations/255361
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