ArticleDiabetology & metabolic syndrome2026
Association of dual SGLT-2 inhibitor and GLP-1 receptor agonist therapy with colon cancer risk in post-polypectomy patients with diabetes: a target trial emulation.
Article in Diabetology & metabolic syndrome, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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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.
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Who cites it
1 citing paper in PubMed, 1 synthesis or guideline pooled it.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPatients with type 2 diabetes mellitus (T2DM) have an elevated risk of colorectal cancer. SGLT-2 inhibitors and GLP-1 receptor agonists have demonstrated potential anticancer properties through distinct mechanisms. However, the association of combination therapy with colon cancer risk remains unknown.
methodsWe conducted a target trial emulation using the TriNetX Global Collaborative Network (2017–2025). Adults with T2DM and a history of polypectomy receiving dual therapy (SGLT-2 inhibitor plus GLP-1 receptor agonist) were compared with SGLT-2 inhibitor monotherapy using 1:1 propensity score matching without replacement. A new-user design and 180-day landmark analysis were employed to address immortal time bias. The primary outcome was incident colon cancer. Secondary outcomes included colectomy, other gastrointestinal cancers, cardiovascular events, renal outcomes, and all-cause mortality. Bonferroni correction was applied for multiple secondary comparisons (α = 0.05/11 = 0.0045).
resultsAfter propensity score matching, 28,934 patients were included in each group. Dual therapy was associated with a lower risk of colon cancer compared with SGLT-2 inhibitor alone (HR 0.786, 95% CI 0.671–0.919; P = 0.003), representing a 21% relative risk reduction (NNT = 490 over 5 years). Significant reductions were also observed in colectomy (HR 0.456), other gastrointestinal cancers (HR 0.690), end-stage renal disease (HR 0.808), major adverse kidney events (HR 0.710), and all-cause mortality (HR 0.658). Negative control outcomes showed no meaningful differences, supporting study validity.
conclusionsIn post-polypectomy T2DM patients, dual therapy was associated with a 21% lower risk of colon cancer versus SGLT-2 inhibitor monotherapy. Co-primary analysis demonstrated this association also persisted when comparing dual therapy against GLP-1 receptor agonist monotherapy alone (HR 0.871; P = 0.041), indicating additive chemopreventive effects of the combination warranting prospective investigation.
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