A Meta-Analysis on the Risk of Esophageal Cancer in Type 2 Diabetes Patients Treated with GLP-1 Receptor Agonists

Qi Wu ^1,2 Yan Zeng ² Man Guo ³ Tie jun Zhou ¹ Zong-zhe Jiang ³ Yong Xu ^2,3*

• ¹ Department of Pathology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan Province, China
• ² Faculty of Chinese Medicine, Macau University of Science and Technology, Macau, Macau Region, China
• ³ The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, China

Objective To evaluate the association between glucagon-like peptide-1 receptor agonists (GLP-1 RAs) treatment and the risk of esophageal cancer in adults with type 2 diabetes mellitus (T2DM) or obesity through a comprehensive meta-analysis.Methods A systematic computerized searches and collection of eligible randomized controlled trials (RCTs) was performed to compare the risk of esophageal cancer between GLP-1 RA and control agents. The bias risks and quality of the studies were evaluated, and a meta-analysis was conducted using Stata 18.0 and R 4.0.2 statistical software.The meta-analysis included data from six studies involving 12,925 participants.The pooled relative risk (RR) of esophageal cancer in patients with T2DM using GLP-1 RAs compared to control agents was 0.46 (95% CI 0.13-1.59; p=0.725; I² =0%).Subgroup analyses stratified by age groups, intervention durations, BMI categories, and indications for T2DM or obesity treatment more often indicated no association between GLP-1 RA use and increased risk of esophageal cancer.Conclusions GLP-1 RA did not increase the incidence of esophageal neoplasms, and there were not probably significant within-class differences in T2DM or obesity treatment. This finding supports the safety of GLP-1 RAs as a therapeutic option for the clinical management of T2DM.