GLP-1RAs Reduce the Risk of Early-Onset Colorectal Cancer in Adults with T2D

The use of glucagon-like peptide 1 receptor agonists (GLP-1 RAs) is associated with a significantly decreased risk of early-onset colorectal cancer (EO-CRC) in patients with type 2 diabetes (T2D) regardless of weight, according to new research.

The findings from a retrospective analysis of approximately 2 million drug-naïve adults with a diagnosis of T2D were presented at the American College of Gastroenterology (ACG) 2024 Annual Scientific Meeting, held October 25-30, 2024, in Philadelphia, Pennsylvania.

“Our findings provide evidence of GLP-1RAs as a potential protective agent against early-onset CRC, which is relevant given the disease’s rising incidence and mortality worldwide,” presenting author Temitope Olasehinde, MD, resident physician, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, Ohio, and colleagues wrote in the poster abstract.

GLP-1RAs are primarily used to treat T2D and obesity, which are 2 important risk factors for the development of CRC. While previous studies have shown that GLP-1RAs are associated with a reduced risk of late-onset CRC (LO-CRC) in people with T2D, this effect has not been examined for EO-CRC, which has a greater association with T2D and obesity than LO-CRC.

Olasehinde and colleagues 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, according to the abstract.

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.

Results from the primary analysis showed that 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).

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).

“Future randomized controlled studies are needed to validate these findings, which may have significant implications for CRC prevention in younger patients,” Olasehinde et al concluded.

Reference: Olasehinde T, Cooper G, Perez JA. Glucagon-like peptide-1 receptor agonist (GLP-1RA) use reduces risk of early-onset colorectal cancer in patients with type 2 diabetes-mellitus (T2DM). Presented at: ACG 2024; October 25-30, 2024; Philadelphia, PA. Poster P2134.