A Halving of Pancreatic Cancer Risk: Too Good to Be True?

A new study presented at the Annual Scientific Sessions of the American College of Gastroenterology tells us receiving a GLP-1 for diabetes with or without obesity is associated with a halving of pancreatic cancer risk. Is this too good to be true?

Observational, of Course

The first thing to note is that the finding comes from an observational study. Experimental studies of cancer risk present many challenges. So this is hardly unusual.

But it does require some caution for interpreting the results. Professor Naveed Sattar explains:

“This is interesting but one of the big exclusions for GLP-1RAs is prior pancreatitis which is also a risk factor for pancreatic cancer. This means a strong chance of residual confounding – and the hazard ratios almost seem too good to be true.”

Nonetheless Noteworthy

Even with this caution, the study is noteworthy. Scientists organizing these sessions selected it for an outstanding research award at the meeting. And it is consistent with other observations. In JAMA Network Open earlier this year, Lindsay Wang et al found 60% less pancreatic cancer risk in patients with type-2 diabetes receiving a GLP-1.

For patients with diabetes, pancreatic cancer risk is higher. And pancreatic cancer is one of a number of cancers for which obesity seems to raise the risk. So it is at least reassuring that GLP-1 therapies are unlikely to add to this risk.

But looking forward it will be important to know if therapies like semaglutide and tirzepatide can really lower the risk of cancer associated with obesity. We have reasons to hope this might be true, but it will take time to work out the facts through careful research.

Click here for the latest research and here for the Wang study. For further perspective, click here and here.

Pancreatic Desmoplasia, photograph by Neelima Shah and Edna Cukierman, Fox Chase Cancer Center, National Cancer Institute, National Institutes of Health, licensed under CC BY-NC 2.0

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November 25, 2024