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A recent study has raised concerns about the potential link between glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and thyroid cancer, particularly during the first year of treatment. While the absolute risk remains low, the study, published on January 23 in JAMA Otolaryngology–Head & Neck Surgery, indicates a notable short-term increase in the risk for thyroid cancer among individuals using these drugs.
The study, led by Dr. Juan P. Brito from the Mayo Clinic, aimed to estimate the risk of thyroid cancer in adults with type 2 diabetes receiving GLP-1 RA therapy compared to those on other commonly prescribed glucose-lowering medications. The research analyzed data from over 350,000 patients, with groups starting treatment with GLP-1 RAs (41,112 patients), dipeptidyl peptidase-4 inhibitors (DPP4i, 76,093 patients), sodium-glucose cotransporter 2 inhibitors (SGLT2i, 43,499 patients), and sulfonylurea therapy (191,209 patients).
The findings revealed that 0.17% of patients in the GLP-1 RA group were diagnosed with thyroid cancer, compared to 0.23% in the DPP4i group, 0.17% in the SGLT2i group, and 0.20% in the sulfonylurea group. However, no significant increase in overall thyroid cancer risk was observed for GLP-1 RA users when compared to other diabetes medications, with a hazard ratio (HR) of 1.24.
The study found that the risk for thyroid cancer was elevated during the first year of GLP-1 RA treatment, with an HR of 1.85. This increased risk was further amplified when restricting the analysis to patients who continued their therapy without discontinuation or switching medications, reaching an HR of 2.07. These results suggest that the heightened risk during the initial year of treatment may be due to increased monitoring and case detection rather than new cancer development.
Dr. Brito and his team emphasized that while the short-term risk is higher, the overall risk for thyroid cancer remains low among patients receiving GLP-1 RA therapy. They suggested that the elevated detection rate is likely attributed to the careful monitoring of patients in the early stages of treatment.
As with all medications, patients are advised to discuss the potential risks and benefits of GLP-1 RAs with their healthcare provider, particularly if they have concerns about thyroid cancer.
Disclaimer: This study highlights an association rather than a direct cause-and-effect relationship between GLP-1 RA use and thyroid cancer risk. The findings are based on observational data, and further research is needed to fully understand the long-term implications of GLP-1 RA therapy on thyroid health. Always consult a medical professional before making any changes to your treatment plan.
