Glucagon-Like Peptide-1 Receptor Agonists and Cancer

To the Editor Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have become among the most widely used medications worldwide, though their use has raised concerns regarding a potential increased risk of cancer. Dai et al conducted a retrospective cohort study assessing the incidence of 13 distinct cancers, which yielded a pooled hazard ratio (HR) of 0.83 (95% CI, 0.76-0.91), suggesting an overall decreased risk, although a notable increase in risk was identified for kidney cancer. The authors described the risk as follows: “However, GLP-1RAs were associated with a marginally nonsignificant increased risk of kidney cancer (HR, 1.38; 95% CI, 0.99-1.93; P =.04).” The term marginally nonsignificant likely reflects the fact that the lower bound of the CI was 1.0, despite the P value of.04, which is conventionally considered statistically significant. This apparent discrepancy may be attributable to differences in the statistical methods used to calculate the CIs vs the P value.