GLP-1RAs Cut Early Colorectal Cancer Risk in Adults with T2D: Daily Dose

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On October 31, 2024, we reported on a study abstract presented at the American College of Gastroenterology (ACG) 2024 Annual Scientific Meeting that examined the impact of glucagon-like peptide 1 receptor agonist (GLP-1 RA) use on early-onset colorectal cancer risk in patients with type 2 diabetes (T2D) with and without obesity.

The study

Researchers analyzed data from TriNetX, a large federated deidentified health research network, to identify adults aged less than 50 years with diagnosed T2D subsequently prescribed antidiabetic medications who had not received a prior diagnosis of CRC. Additionally, patients were stratified into 2 groups on the basis of first-time GLP-1 RA use. Researchers also performed a subanalysis based on GLP-1RA use and the presence of obesity. The primary outcome was first diagnosis of EO-CRC after GLP-1RA use.

A total of 2 025 034 drug-naïve patients with T2D were identified for the study; of these, 284 685 were in the GLP-1RA group and 1 740 349 were in the non-GLP-1RA arm. Following propensity score matching, there were 86 186 participants in each group.

The findings

Adults in the GLP-1RA group had significantly lower odds of developing EO-CRC compared to the non-GLP-1RA group (0.6% vs 0.9%; P < .001; odds ratio [OR] 0.61, 95% CI 0.54-0.68), according to the results.

In the subanalysis, investigators observed that participants with obesity and receiving GLP-1RAs had significantly lower odds of developing EO-CRC than those with obesity in the non-GLP-1RA group (0.7% vs 1.1%; P < .001; OR 0.58, 95% CI 0.50-0.67).

Authors' comment

"This is the first large study to demonstrate that GLP-1RAs decrease the risk of developing EO-CRC in patients with T2DM regardless of weight. Future randomized controlled studies are needed to validate these findings, which may have significant implications for CRC prevention in younger patients."

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