Use of GLP-1 Receptor Agonists in Adults With Diabetes and a History of Cancer

By
Olinto Linares-Perdomo
Damon Klebe
Fumiko Chino
Bismarck C. Odei
October 7, 2026

Jama Network Open

Overview

In a cross-sectional analysis of 3,615 US adults with diagnosed diabetes, current injectable GLP-1 receptor agonist use was lower among cancer survivors than among adults without a cancer history after adjustment for measured demographic, socioeconomic, and clinical factors. Adjusted standardized use was 20.5% versus 26.5%, respectively, a difference of −6.0 percentage points (95% CI, −6.6 to −5.4).

Background

GLP-1 receptor agonists are used in type 2 diabetes to improve glycemic control, support weight loss, and reduce cardiovascular and kidney risk. The source notes that cancer survivors may have increased cardiometabolic and kidney risk associated with cancer therapies. Prior evidence cited in the article has also associated GLP-1 RA use with better survival in older adults with cancer and type 2 diabetes. This study assessed whether current injectable GLP-1 RA use differed by cancer history among US adults with diabetes.

Data Highlights

Measure	Cancer history	No cancer history
Participants, unweighted	674	2,941
Unadjusted current injectable GLP-1 RA use, weighted % (SE)	20.0 (2.0)	27.9 (1.1)
Adjusted standardized use, % (95% CI)	20.5 (20.1–20.9)	26.5 (26.1–27.0)
Adjusted difference, percentage points (95% CI)	−6.0 (−6.6 to −5.4)
Adjusted odds ratio (95% CI)	0.70 (0.52–0.96)
Mean age, years (SE)	69.0 (0.7)	61.1 (0.3)
Medicare coverage, % (SE)	45.8 (2.5)	33.7 (1.2)
Atherosclerotic cardiovascular disease, % (SE)	33.8 (2.3)	23.6 (0.9)
Chronic kidney disease, % (SE)	19.8 (1.9)	10.9 (0.7)

Key Findings

The 2024 National Health Interview Survey analytic cohort included 3,615 adults with diagnosed diabetes, representing an estimated 26.4 million US adults; 674 had a cancer history and 2,941 did not.
Unadjusted injectable GLP-1 RA use was 20.0% (SE, 2.0%) among cancer survivors and 27.9% (SE, 1.1%) among adults without cancer history.
After adjustment, standardized use remained lower among survivors (20.5% vs 26.5%); the adjusted difference was −6.0 percentage points (95% CI, −6.6 to −5.4), and the adjusted odds ratio was 0.70 (95% CI, 0.52–0.96).
Cancer survivors were older on average and more frequently had Medicare coverage, atherosclerotic cardiovascular disease, and chronic kidney disease than adults without cancer history.
The article reports that prespecified sensitivity analyses using alternative income and comorbidity specifications and restricting analyses to adults with recent outpatient care yielded similar findings.
Related retrospective studies summarized in the supplied context reported associations between GLP-1 RA use and lower risk of certain obesity-associated cancers or overall cancer risk; these studies address cancer incidence, not medication use among cancer survivors.

Clinical Implications

The observed difference describes current injectable GLP-1 RA use by cancer history in a cross-sectional survey and does not establish why use differed or whether cancer history caused the difference. The study assessed a medication question covering injectable, noninsulin drugs used to reduce blood glucose or body weight, and its primary analysis included all adults with diagnosed diabetes; the supplied material does not provide the type 2 diabetes sensitivity-analysis results.

Conclusion

In this nationally representative survey analysis, adults with diabetes and a cancer history had lower adjusted current injectable GLP-1 RA use than those without a cancer history. The cross-sectional findings establish an association and do not determine its causes or clinical consequences.