- People with type 2 diabetes taking an anti-diabetes medication such as semaglutide did not have an increased risk of pancreatic cancer, a new study found.
- These drugs, known as GLP-1 receptor agonists, are used to treat type 2 diabetes and obesity.
- While the results are “comforting,” more research is needed, including longer-term studies, experts say.
People with type 2 diabetes who take an anti-diabetes medication such as semaglutide don’t have a higher risk of developing pancreatic cancer, a new study found.
These drugs called glucagon-like peptide-1 (GLP-1) receptor agonists have skyrocketed in popularity sold under the brand names Ozempic, Wegovy and Mounjaro among others.
“This is a very important study, because it’s a large population-based study with a very good follow-up,” said Dr. Anton Bilchik, surgical oncologist, chief of medicine and director of the Gastrointestinal and Hepatobiliary Program at Saint John’s Cancer Institute in Santa Monica, Calif., who was not involved in the new research.
In general, pancreatic cancer hasn’t been a big concern among people taking these types of medications, said Dr. Mir Ali, bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, Calif.
“First of all, it’s a very rare form of cancer,” he told Healthline, “and second, there hasn’t been a lot of reports of that type of cancer in patients using these drugs.”
“So this study is reassuring, in that if you prescribe these drugs to patients long-term, it’s not increasing their risk for pancreatic cancer,” said Ali, who was not involved in the new research.
The new study was published Jan. 4 in JAMA Network Open.
No increased risk of pancreatic cancer
Dr. Kishore Gadde, a bariatric medicine physician with UCI Health in Orange, Calif., who was not involved in the new study, called the findings “comforting.”
However, he pointed out that some earlier studies have suggested a possible increased risk of pancreatic cancer among people taking these types of medications.
For example, two studies published in 2022 and 2023, which looked at data from the FDA Adverse Events Reporting System (FAERS), “have shown a strong association between use of GLP-1 receptor agonists and pancreatic cancer,” he told Healthline.
Other research, though, including a 2019 meta-analysis of 12 previous studies, found no link between GLP-1 receptor agonists and pancreatic cancer.
Some of these studies had short follow-up periods or followed a relatively limited number of patients, the authors of the new study pointed out.
To address the limitations of these earlier studies, they looked at data on more than 500,000 patients with type 2 diabetes who were prescribed a GLP-1 receptor agonist, and followed people for an average of 6 years.
They found that patients with type 2 diabetes who took a GLP-1 receptor agonist did not have a higher risk of pancreatic cancer.
“At the end of the day, this study is very reassuring,” Bilchik told Healthline, “in that there is no increase in the development of pancreatic cancer in patients taking these drugs.”
The new study was limited to use of these drugs as a treatment for type 2 diabetes, so the findings may not apply to people taking the drugs for weight loss.
Gadde also pointed out that clinical trials for GLP-1 receptor agonists typically exclude people with significant pre-existing pancreatic disease. As a result, he thinks more real-world data and additional large studies are needed.
“Until we have more data, we need to be watchful about the risks of pancreatitis, pancreatic cancer, bowel obstruction and gastroparesis [delayed gastric emptying] when prescribing GLP-1 receptor agonists,” he said.
In addition, new GLP-1 receptor agonists are being developed, said Bilchik, and “they seem to work in slightly different ways, so there needs to be more investigation of some of these other types of drugs.”
Who is at risk for pancreatic cancer?
In the new study, researchers examined electronic medical records from 543,595 patients with type 2 diabetes. The data came from the largest health maintenance organization in Israel and the Israel Cancer Registry.
The study included more than 33,000 people who were treated with a GLP-1 receptor agonist, as well as those who weren’t. The average age of patients was 60 years, with around half female.
In addition, 79% of people had overweight or obesity, and more than one-third had a history of smoking tobacco products. Around 3% of people had a history of pancreatitis.
During the 9-year follow-up period, 1,665 patients were diagnosed with pancreatic cancer. These patients tended to be older and have a lower body mass index (BMI), compared to those without pancreatic cancer.
However, there were similar rates of pancreatic cancer among people who took a GLP-1 receptor agonist and those who didn’t, researchers found.
Patients who used only insulin to treat their diabetes had a slightly higher rate of pancreatic cancer, but researchers said this is “most probably due to their older age and longer diabetes duration.”
How Ozempic, Wegovy and similar drugs may lower cancer risk
Bilchik agrees that longer-term studies are needed, in particular, to look at whether GLP-1 receptor agonists actually lower the risk of pancreatic cancer. Past research has found that these drugs have lowered the risk of cardiovascular disease likely in part by reducing obesity.
“So many cancers are related to obesity,” he said, “so it seems logical that if we’re going to see a reduction in obesity in these patients that they will be at lower risk for developing obesity-related diseases, of which pancreatic cancer is one.”
This would be an important finding, he said, especially since the rates of pancreatic cancer cases and deaths have remained largely unchanged over the past 20 years, “unlike the significant improvement seen with other cancers.”
“Any reduction in the development of pancreatic cancer would have a significant impact in healthcare,” he said.
Takeaway
A large real-world study found that patients with type 2 diabetes who took a GLP-1 receptor agonist such as Ozempic or Wegovy did not have an increased risk of pancreatic cancer. This contrasts with earlier studies which found a possible increased risk.
GLP-1 receptor agonists are approved as a treatment for type 2 diabetes, with some now approved for treating obesity. Doctors may also prescribe these drugs off-label as an obesity treatment.
Experts say longer-term studies are needed to confirm the results and to see if the drugs can lower the risk of pancreatic cancer by reducing obesity. Obesity increases the risk of pancreatitis, which itself is a risk factor for pancreatic cancer.
