Glucagon-like peptide-1 receptor agonists and risk of pancreaticobiliary cancers in patients with type 2 diabetes: a nationwide cohort study
Main finding · Incident pancreatic cancer (adjusted HR, GLP-1RA vs DPP-4i)Result — go to the resultAdjusted hazard ratio 0.668 95% CI 0.476–0.939Authors' conclusion
In this large cohort study, GLP-1RA use was associated with reduced pancreatic cancer risk compared with DPP-4i use among patients with T2D. Similar trends were observed for other pancreaticobiliary cancers.
Study context
- Population
- Patients with T2D receiving metformin plus SU, Korean National Health Insurance Service data 2011–2023
- Participants
- 51,780 patients
- Exposure
- GLP-1 RA vs DPP-4i
- GLP-1RAn = 24,052
- DPP-4in = 27,728reference
- Outcome
- Incident pancreatic cancer, bile duct cancer, gallbladder cancer and composite pancreaticobiliary cancer
- Follow-up
- Mean 4.0 years
Methodological detailsnationwide, Cox proportional hazards models adjusted for demographics, comorbidities and previous diabetes medications
- Nationwide
- Cox proportional hazards models adjusted for demographics, comorbidities and previous diabetes medications
Main finding
As reported in the abstract
Incident pancreatic cancer (adjusted HR, GLP-1RA vs DPP-4i) · mean 4.0 years follow-up
Adjusted hazard ratio
0.668
95% CI 0.476–0.939
GLP-1RAvs DPP-4i
adjusted HR 0.668 (95% CI 0.476–0.939)
- Bile duct cancer, adjusted HR (95% CI 0.375-1.124); similar trend
- 0.649
- Gallbladder cancer, adjusted HR (95% CI 0.171-1.019); similar trend
- 0.418
- Composite pancreaticobiliary cancer, adjusted HR (95% CI 0.515-0.901); similar trend
- 0.681
- Pancreaticobiliary cancers occurred
- 321
Observational data: associations, not effects.
Further findings
Sensitivity analyses: propensity score-matched; excluding baseline pancreaticobiliary disease
- Associations remained consistent
- Propensity score-matched analysis
Original publication
Glucagon-like peptide-1 receptor agonists and risk of pancreaticobiliary cancers in patients with type 2 diabetes: a nationwide cohort study. Diabetes Metab. Published 25 June 2026. doi:10.
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