TOPLINE:

In patients with type 2 diabetes (T2D), the use of GLP-1 receptor agonists was associated with a significantly lower risk for lung cancer than the use of DPP-4 inhibitors. GLP-1 receptor agonist use was also linked to significantly lower risks for influenza, pneumonia, lung infections, and pulmonary fibrosis.

METHODOLOGY:

• Researchers conducted a retrospective cohort study using data from the TriNetX US Network electronic health record database to evaluate whether initiating GLP-1 receptor agonists rather than other antihyperglycemic agents affected the incidence rates of lung cancer, respiratory infections, and pulmonary fibrosis in patients with T2D.
• Patients with a confirmed T2D diagnosis and at least three clinical visits between January 2005 and December 2020 were divided into two propensity score-matched groups, with 158,224 patients in each group: new GLP-1 receptor agonist users (mean age, 56.7 years; 44.5% male) and new DPP-4 inhibitor users (mean age, 56.4 years; 44.5% male).
• The primary outcome was the incidence of lung cancer, with additional analyses examining specific tumor sites.
• Secondary outcomes included influenza, pneumonia, acute lower lung infections, suppurative lung disease, and pulmonary fibrosis.
• Outcomes were analyzed from 90 days up to 10 years after first exposure to medication; the median follow-up duration was 1882 days for GLP-1 receptor agonist users and 2078 days for DPP-4 inhibitor users.

TAKEAWAY:

• GLP-1 receptor agonist users had a 14% lower risk for lung cancer than DPP-4 inhibitor users (hazard ratio [HR], 0.86; 95% CI, 0.80-0.94); a decrease in risk was also observed for bronchial cancers.
• GLP-1 receptor agonist users were also associated with lower risks for secondary outcomes than DPP-4 inhibitor users, including influenza and pneumonia (HR, 0.94), acute lower lung infections (HR, 0.85), suppurative lung disease (HR, 0.74), and pulmonary fibrosis (HR, 0.92).
• GLP-1 receptor agonist users had a lower risk for lung cancer than users of insulin, biguanides, sulfonylureas, or thiazolidinediones but a similar risk to SGLT2 inhibitor users.
• The protective effect of GLP-1 receptor agonist use against lung cancer was consistent across multiple demographic subgroups.

IN PRACTICE:

“Our findings indicate that GLP-1 RAs [receptor agonists] significantly lower the risk of lung cancer and may improve lung health, reinforcing their protective effects on pulmonary disease beyond glycemic control,” the authors of the study wrote.

SOURCE:

The study was led by Li-Ti Ho, Shin Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan. It was published online on October 13, 2025, in Scientific Reports.

LIMITATIONS:

Because the study was retrospective, it was subject to inherent biases and could not establish causation. Data on key lung cancer risk factors — such as smoking history, occupational exposures, air pollution, and family history — were not available, and imbalances in these factors between groups may have affected findings. The use of TriNetX data may have introduced coding errors, and information on medication adherence and actual drug use was unavailable.

DISCLOSURES:

No funding was provided for this study, and the authors reported having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.