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# GLP-1 pancreatic cancer hazard shifts with the comparator diabetes drug
- URL: https://www.coios.me/glp-1-pancreatic-cancer-hazard-shifts-with-the-comparator/
- Published: 2026-09-17T09:25:20.000Z
- Updated: 2026-09-17T09:25:20.000Z
- Description: In a TriNetX cohort of adults with type 2 diabetes, GLP-1 receptor agonist initiators had a lower hazard of pancreatic cancer than insulin users (HR 0.43), higher hazards than metformin, sulfonylurea, thiazolidinedione and DPP-4 users, and no difference against SGLT2 inhibitors.
- Author: Daniel Ryan
- Tags: Healthcare today, Cancer, Obesity, diabetes and the GLP-1 drugs, United States, #peer-reviewed, #refines, #item, #source-2026-09

A new-user retrospective cohort in the TriNetX electronic health record network compared adults with type 2 diabetes starting a GLP-1 receptor agonist with initiators of six other antidiabetic classes, in six separate propensity-score-matched analyses on 39 covariates, for incident pancreatic cancer between one and twenty years after the index prescription. Relative to insulin the hazard for GLP-1 users was 0.43 (95% CI 0.35-0.53); relative to metformin, sulfonylureas, thiazolidinediones and DPP-4 inhibitors the hazards ran the other way (HRs 1.30-1.39), and no difference was seen against SGLT2 inhibitors. Absolute risk differences were 0.04 to 0.15 percentage points, and the reported absolute risks against insulin sit awkwardly with the hazard ratio.

*Why it is interesting: The pancreatic cancer signal for the incretin drugs flips direction depending on the comparator chosen, which is itself the finding about how these EHR analyses are read.*

Source

[Journal of gastrointestinal cancer, 2026-09-16](https://doi.org/10.1007/s12029-026-01523-w?ref=coios.me)

DOI

10.1007/s12029-026-01523-w

Type

Peer-reviewed article

Design

Retrospective new-user cohort in the TriNetX federated EHR network, adults with type 2 diabetes, six separate 1:1 propensity-score-matched comparisons on 39 covariates, outcome incident pancreatic cancer 365-7,300 days after index

Verdict

Refines prior evidence

Driver

[Cancer](https://www.coios.me/d-cancer/)

Driver

[Obesity, diabetes and the GLP-1 drugs](https://www.coios.me/d-obesity-diabetes/)