A large-scale study is the first to demonstrate an association between GLP-1 receptor agonists use and reduced early-onset colorectal cancer risk in patients with T2DM, independent of weight. commonly prescribed for type 2 diabetes mellitus (T2DM) and obesity, reported researchers at the American College of Gastroenterology scientific meeting in Philadelphia, Pennsylvania.

The poster was presented by Temitope Olasehinde, MD, from University Hospitals Cleveland Medical Center, Case Western Reserve University, in Cleveland, Ohio.

Prior studies have shown GLP-1RAs to decrease the risk of late-onset colorectal cancer (LO-CRC) in T2DM, yet their effect on EO-CRC—whose incidence has been rising and is more strongly associated with T2DM and obesity—remains unexplored.

Using the TriNetX health network, researchers identified a cohort of T2DM patients with no prior colorectal cancer (CRC) diagnosis, stratifying them by GLP-1RA use and conducting a subanalysis based on obesity. Out of 1,815,788 patients with T2DM, 247,463 had used GLP-1RAs, while 1,568,325 had not. After propensity score matching, each group contained 77,688 patients, balanced for baseline characteristics. The GLP-1 cohort was generally older, with a higher BMI, and more comorbidities than the non-GLP-1 cohort.

The primary analysis revealed that the GLP-1 cohort had significantly lower odds of developing EO-CRC compared to the non-GLP-1 cohort (0.4% vs 0.7%, p < 0.001). In the subanalysis, patients with obesity who used GLP-1RAs also showed a significantly reduced risk of EO-CRC compared to patients with obesity who did not use GLP-1RAs.

These findings suggest potential preventive benefits of GLP-1RAs in EO-CRC, warranting further randomized trials to confirm these results and guide CRC prevention strategies for younger, at-risk populations.

Reference
Olasehinde T, Cooper G, Perez J, et al. 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: American College of Gastroenterology; October 25-30,2024. Philadelphia, PA.