# Do GLP-1 Drugs Cause Pancreatic Cancer? Six Comparators, Five Answers A TriNetX propensity-matched study compared GLP-1 users with six antidiabetic classes on pancreatic cancer | hazard ratios ran 1.08 to 1.39, on 0.04 to 0.15 point risk differences. Publisher: This GLP Editorial Team Canonical: https://thisglp.com/research/do-glp1-drugs-cause-pancreatic-cancer Updated: 2026-09-17 Published: 2026-09-16 [← Research](https://thisglp.com/research) Evidence # Do GLP-1 Drugs Cause Pancreatic Cancer? Six Comparators, Five Answers Against four rival drug classes the GLP-1 arm carried the lower hazard, and against SGLT2 inhibitors no difference. One of the six comparisons is printed in both directions in the same abstract. [This GLP Editorial Team](https://thisglp.com/about)September 20269 min readUpdated September 2026 Pancreatic cancer, comparator versus GLP-1 user · above 1.00 means the comparator drug carried the higher hazard · metformin · 1.39 (1.16–1.66) · +0.04 pts · sulfonylureas · 1.37 (1.13–1.65) · +0.07 pts · DPP-4 inhibitors · 1.31 (1.06–1.61) · +0.08 pts · thiazolidinediones · 1.30 (1.001–1.678) · +0.15 pts · SGLT2 inhibitors · 1.08 (0.87–1.34) · no difference · insulin — the abstract reports this one in both directions · HR 0.43 (0.35–0.53), risks 0.15% against 0.11%, conclusion: higher **Research, not medical advice.** This GLP is independent and educational. Nothing here is a substitute for individualized care from a licensed clinician, and reading it creates no doctor–patient relationship. Talk to your own provider before starting, stopping, or changing any medication, peptide, or therapy. See our [methodology](https://thisglp.com/methodology) and [terms](https://thisglp.com/terms). ## Key takeaways - A new-user cohort study in the TriNetX record network, adults with type 2 diabetes starting a GLP-1 drug. - Six separate 1:1 propensity-matched comparisons, one per rival drug class, matched on 39 covariates. - The answer changed with the comparator: lower than four classes, no different from SGLT2 inhibitors. - The insulin comparison is printed in both directions in the same abstract. - Every absolute risk difference sits between 0.04 and 0.15 percentage points. Nothing here says they do. Across six separate matched comparisons, the GLP-1 arm carried a lower hazard than four rival drug classes and no different a hazard from SGLT2 inhibitors. Every absolute difference sits between 0.04 and 0.15 percentage points [\[1\]](https://thisglp.com/research/do-glp1-drugs-cause-pancreatic-cancer#ref-1). One comparison in the paper is printed three times, in two directions, and that is the part worth your attention. It sits inside a design that was otherwise careful, and beside [the larger matched-record study on cancer overall](https://thisglp.com/research/do-glp1-drugs-cause-kidney-cancer). ## What was compared with what Adults with type 2 diabetes who started a GLP-1 drug were matched one-to-one against adults who started insulin, metformin, a DPP-4 inhibitor, an SGLT2 inhibitor, a sulfonylurea or a thiazolidinedione. Matching used 39 baseline variables covering demographics, conditions, procedures and other prescriptions. The outcome was a pancreatic cancer diagnosis recorded between 365 and 7,300 days after the first prescription. That first year is deliberately discarded, because pancreatic cancer often causes diabetes months before anyone finds the tumor. Without the gap, the drug someone was prescribed for their new diabetes would look like the cause of the cancer that produced it. ## Four lower, one level Against metformin the hazard ratio was 1.39, interval 1.16 to 1.66, in the comparator’s direction — so the metformin group carried the higher hazard. Sulfonylureas gave 1.37, DPP-4 inhibitors 1.31, thiazolidinediones 1.30 with an interval of 1.001 to 1.678. SGLT2 inhibitors gave 1.08, and that interval crosses one. Read one at a time, each is a separate observational study with its own matched population. We have [written about what that does to an answer](https://thisglp.com/research/glp1-adolescent-suicidality-comparators) and will not repeat it here. What is new is the sixth row. The insulin row disagrees with itself The results section says GLP-1 users had a lower hazard than insulin users, HR 0.43 with an interval of 0.35 to 0.53. The same sentence prints absolute risks of 0.15% on a GLP-1 against 0.11% on insulin, which runs the other way. The conclusions then describe a higher hazard relative to insulin. Those three statements cannot all be right. We cannot tell from the abstract which is the slip, so we are not going to pick one. What we can say is that the insulin comparison is the one nobody should quote yet. ## How large are these differences Small. The absolute risk differences run from 0.04 to 0.15 percentage points, on underlying risks of roughly one in a thousand. A hazard ratio of 1.39 sounds like a third more cancer. In this data it is about four extra diagnoses per ten thousand people over a period that can run twenty years. Ratios and counts are two different sentences, and [a large ratio on a small base](https://thisglp.com/research/glp1-prescriptions-to-young-children) is the easiest number on a page to misread. ## What matching does not fix Nobody here was randomized. People put on insulin have usually had diabetes longer and controlled it worse, and 39 covariates do not erase that. The comparison against insulin is the one most likely to be carrying it, which makes the contradiction in that row doubly awkward. The record network also only knows what was coded. A diagnosis appears when somebody wrote it down, and so do the conditions used to match on — the same limitation behind [the other large matched-record study on cancer](https://thisglp.com/research/do-glp1-drugs-cause-kidney-cancer). ## What the wider cancer evidence adds A separate matched cohort of 86,632 adults looked at cancer overall rather than one organ[\[2\]](https://thisglp.com/research/do-glp1-drugs-cause-pancreatic-cancer#ref-2). Incidence across fourteen cancers ran 13.6 per 1,000 person-years in GLP-1 users against 16.4 in non-users, a hazard ratio of 0.83 (95% CI 0.76 to 0.91). Pancreatic cancer is not reported separately there, so the two studies answer adjacent questions rather than the same one. Both are record studies and both share the coding problem. Neither is a trial. What they agree on is a direction, and the direction is away from harm. ## What to take from it No signal that GLP-1 drugs cause pancreatic cancer. That is the useful finding, and it is a negative one. Anything stronger runs into the comparator problem. “Lower risk” is not a property a drug has on its own, and a difference of [a fraction of a percentage point](https://thisglp.com/research/glp1-liver-cancer-absolute-risk) is not something a person can feel either way. ## Frequently asked Do GLP-1 drugs cause pancreatic cancer? This study found no signal that they do. Against four other drug classes the GLP-1 group carried the lower hazard, and against SGLT2 inhibitors there was no difference. Why does the answer change with the comparator? Because every result is a comparison. Each of the six analyses matched a different population, so the number describes the pair of drugs rather than the GLP-1 alone. How big were the differences? Between 0.04 and 0.15 percentage points, on underlying risks near one in a thousand. A hazard ratio of 1.39 here is about four extra diagnoses per ten thousand people. What is wrong with the insulin comparison? The published abstract reports it in both directions — a lower hazard in the results, absolute risks running the other way, and a higher hazard in the conclusions. It should not be quoted until that is resolved. ## Sources 1. \[1\] Kazi MAI, et al. (2026). Long-Term Association Between GLP-1 Receptor Agonist Use and Incident Pancreatic Cancer: A Propensity Score-Matched Retrospective Cohort Study Using the TriNetX Network Journal of Gastrointestinal Cancer. [PMID 42745130](https://pubmed.ncbi.nlm.nih.gov/42745130/) 2. \[2\] Dai H, et al. (2025). GLP-1 Receptor Agonists and Cancer Risk in Adults With Obesity JAMA Oncology. [PMID 40839273](https://pubmed.ncbi.nlm.nih.gov/40839273/) ## Where to get it ### Best GLP-1 injections Every injectable seller we can verify, with the price each one publishes and an honest read of what the trials measured. [Compare providers →](https://thisglp.com/best/compounded-semaglutide) ## More in Evidence - [ 150 minutes · Weekly activity goal · 2 days · Muscle strengthening · Adapt · Symptoms and ability ### Exercise on Ozempic: Building Strength Without Ignoring Symptoms ](https://thisglp.com/research/exercise-on-ozempic) - [ STEP 1, semaglutide 2.4 mg vs placebo, % change at 68 weeks · LDL cholesterol · −2.5% vs +1.3% · Total cholesterol · −3.3% vs +0.1% · HDL cholesterol · +5.2% vs +1.4% · Triglycerides · −21.9% vs −7.3% · Wegovy label, Table 13. Adults without diabetes. Ozempic doses are lower. ### Does Ozempic Lower Cholesterol? What the Lipid Results in the Trials Show ](https://thisglp.com/research/does-ozempic-lower-cholesterol) - [ Where the insulin reduction came from, units per day · week 4 · 13.4 total · week 26 · 21.9 · the drug itself · the weight loss · The drug’s own contribution barely moved: 11.1 then 11.4. · Everything added between weeks 4 and 26 came from weight. ### Does Semaglutide Help Type 1 Diabetes? What Two Small Trials Found ](https://thisglp.com/research/semaglutide-in-type-1-diabetes)