Evidence mapPaperPMID 41057208Full record

ArticleBMJ open diabetes research & care2025

Investigating the association between incretin-based therapies and thyroid cancer incidence among US Medicare beneficiaries with diabetes.

Clement O Acheampong, John B Buse, Klara R Klein, Lawrence T Kim, Joshua Evron, Anna R Kahkoska, Caroline A Thompson, Tiansheng Wang, Virginia Pate, Peter Leese and 1 more

Abstract read
In one paragraph

Article in BMJ open diabetes research & care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Clement O AcheampongDepartment of Epidemiology, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.ORCID http://orcid.org/0000-0001-8840-025X
John B BuseDivision of Endocrinology, Department of Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.ORCID http://orcid.org/0000-0002-9723-3876
Klara R KleinDivision of Endocrinology, Department of Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.ORCID http://orcid.org/0000-0002-5894-9054
Lawrence T KimDivision of Surgical Oncology and Endocrine Surgery, Department of Surgery, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.
Joshua EvronDivision of Endocrinology, Department of Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.
Anna R KahkoskaDivision of Endocrinology, Department of Medicine, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.ORCID http://orcid.org/0000-0003-2701-101X
Caroline A ThompsonDepartment of Epidemiology, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.
Tiansheng WangDepartment of Epidemiology, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.ORCID http://orcid.org/0000-0002-0980-8896
Virginia PateDepartment of Epidemiology, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA.
Peter LeeseNC TraCS Institute, The University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.
Til StürmerDepartment of Epidemiology, The University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, North Carolina, USA sturmer@unc.edu.ORCID http://orcid.org/0000-0002-9204-7177

Funding

CTSA K12 Program at UNCK12TR004416 · UNIV OF NORTH CAROLINA CHAPEL HILL · 2025 to 2025
$1.6M
Pilot & Feasibility ProgramP30DK124723 · WAKE FOREST UNIVERSITY HEALTH SCIENCES · 2025 to 2025
$1.6M
Propensity scores and preventive drug use in the elderlyR01AG056479 · UNIV OF NORTH CAROLINA CHAPEL HILL · 2025 to 2025
$558k
Building a Real-World Evidence Base for Continuous Glucose Monitoring in Older Adults with DiabetesK01AG084971 · UNIV OF NORTH CAROLINA CHAPEL HILL · 2025 to 2025
$127k
NCATS NIH HHS K12 TR004416NCATS NIH HHS UL1 TR002489NIA NIH HHS K01 AG084971NIA NIH HHS R01 AG056479NIDDK NIH HHS P30 DK124723
6 · The paper itself

Abstract

introductionPreclinical studies suggest a potential link between glucagon-like peptide 1 receptor agonists (GLP-1RA) and thyroid cancer (TC), yet it is unclear if this risk translates to humans. RESEARCH DESIGN AND

methodsWe estimated the comparative effect of incretin-based therapies (GLP-1RA and dipeptidyl-peptidase-4 inhibitors (DPP-4i)) versus sodium-glucose cotransporter-2 inhibitors (SGLT-2i) on TC incidence among US older adults with type 2 diabetes. We defined TC as a thyroidectomy followed by ≥2 separate diagnoses codes for malignant neoplasm of thyroid gland within 90 days. We estimated adjusted 3-year cumulative risk differences of TC (aRDs) with 95% CIs using weighted Kaplan-Meier survival functions, and adjusted HRs using weighted Cox models.

resultsWe included 73 388 new users in the GLP-1RA versus SGLT-2i cohort (mean age 72.4 years, men: 48.3%) and 106 274 in the DPP-4i versus SGLT-2i cohort (mean age 74.6 years, men: 44.9%). At 3 years and a median duration of treatment of 0.82-1.15 years, the aRD for GLP-1RA versus SGLT-2i for TC was -23 per 10 000 (95% CI: -51 to 4) and the aRD for DPP-4i versus SGLT-2i was -2 per 10 000 (95% CI: -17 to 13). Secondary and sensitivity analyses were consistent.

conclusionsOur study of US Medicare beneficiaries with type 2 diabetes suggests that the initiation of incretin-based therapies may not increase the 3-year risk of TC compared with initiation of SGLT-2i. This finding offers reassurance for short-term use but does not eliminate the possibility of increased long-term or subtype-specific risks.

Indexed as

Diabetes Mellitus, Type 2Hypoglycemic AgentsIncretinsThyroid NeoplasmsAgedAged, 80 and overDipeptidyl-Peptidase IV InhibitorsFemaleFollow-Up StudiesHumansIncidenceMaleMedicareRisk FactorsSodium-Glucose Transporter 2 InhibitorsUnited StatesDipeptidyl-Peptidase IV InhibitorsHypoglycemic AgentsIncretinsSodium-Glucose Transporter 2 InhibitorsCancerCohort StudiesDiabetes Mellitus, Type 2Incretins

Identifiers

PMID41057208
PMCPMC12506239

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.