The DOI matches its Crossref record; 9 of the 9 references it cites were found in a registry or an index.
Response to Comment on Bezin et al. GLP-1 Receptor Agonists and the Risk of Thyroid Cancer. Diabetes Care 2023;46:384–390
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The potential for residual confounding and the role of surveillance bias are important considerations that have not been thoroughly assessed.
“Similarly, the potential for residual confounding (e.g., limited evaluation of specific risk factors for thyroid cancer such as obesity, neck radiation, and family history of thyroid cancer) and the role of surveillance bias (e.g., clinicians might be more likely to do a thyroid exam or ultrasound on patients taking GLP-1 RA) are important considerations that have been not thoroughly assessed.25,”
From Glucagon-Like Peptide-1 Receptor Agonists and Thyroid Cancer: A Narrative Review (2024) · cites this paper as [54]
In the opening paragraphs (page not supplied), the authors acknowledge potential residual confounding, including imperfectly captured obesity, although they also report additional obesity-adjusted analyses and an E-value calculation. Our copy does not assess whether GLP-1 RA users receive more thyroid examinations or ultrasounds, and it does not discuss family history or neck radiation as confounders. Its discussion of notoriety bias concerns pharmacovigilance reporting, not the clinical surveillance bias described in the claim. (LLM, conf=0.85)
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Citations
Cites
Sensitivity analysis in observational research: Introducing the E-value
VanderWeele, T. J., & Ding, P. (2017) · Annals of Internal Medicine · doi:10.7326/m16-2607 · Cited by 6,350
GLP-1 Receptor Agonists and the Risk of Thyroid Cancer
Bezin, J., Gouverneur, A., Pénichon, M., Mathieu, C., Garrel, R., Hillaire-Buys, D., Pariente, A., & Faillie, J.-L. (2023) · Diabetes Care · doi:10.2337/dc22-1148 · Cited by 320
Self-citationImpact of Safety Alerts on Measures of Disproportionality in Spontaneous Reporting Databases
Pariente, A., Grégoire, F., Fourrier‐Réglat, A., Haramburu, F., & Moore, N. D. (2007) · Drug Safety · doi:10.2165/00002018-200730100-00007 · Cited by 270
Self-citationHu, W., Song, R., Cheng, R., Liu, C., Guo, R., Tang, W., Zhang, J., Zhao, Q., Li, X., & Liu, J. (2022) · Frontiers in Endocrinology · doi:10.3389/fendo.2022.927859 · Cited by 127
Putting GLP-1 RAs and Thyroid Cancer in Context: Additional Evidence and Remaining Doubts
Thompson, C. A., & Stürmer, T. (2023) · Diabetes Care · doi:10.2337/dci22-0052 · Cited by 51
Goldenberg, R., & Jain, A. (2023) · Diabetes Care · doi:10.2337/dc22-2300 · Cited by 9
Smits, M. M., & van Raalte, D. H. (2023) · Diabetes Care · doi:10.2337/dc23-0134 · Cited by 7
Endo, M., Roth, M. Y., Tylee, T. S., DeSantis, A., & Hirsch, I. B. (2023) · Diabetes Care · doi:10.2337/dc22-2454 · Cited by 6
Mañas-Martinez, A. B., & Gimeno-Orna, J. A. (2023) · Diabetes Care · doi:10.2337/dc23-0076 · Cited by 5
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Wang, L., Xu, R., Kaelber, D. C., & Berger, N. A. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.21305 · Cited by 304
Silverii, G. A., Monami, M., Gallo, M., Ragni, A., Prattichizzo, F., Renzelli, V., Ceriello, A., & Mannucci, E. (2024) · Diabetes Obesity and Metabolism · doi:10.1111/dom.15382 · Cited by 113
“21,22,56 59 The issue of the biological plausibility of the association of GLP-1RA treatment with thyroid cancer is complex.”
Glucagon-Like Peptide-1 Receptor Agonists and Thyroid Cancer: A Narrative Review
Espinosa De Ycaza, A. E., Brito, J. P., McCoy, R. G., Shao, H., & Singh Ospina, N. (2024) · Thyroid · doi:10.1089/thy.2023.0530 · Cited by 37
“25,38 54 Of note, the strength of the association of GLP-1 RA as a risk factor for the diagnosis of thyroid cancer is inconsistent in this body of evidence, as it varies according to study designs (e.g., case–control vs. cohort) and sensitivity and sub-group analyses (e.g., types of codes used for…”
Daou, C. A. Z., Hosn, O. A., Ghzayel, L., & Mourad, M. (2025) · Endocrinology Diabetes & Metabolism · doi:10.1002/edm2.70038 · Cited by 19
“A recent study utilising the French National Health Cancer Data System found that using GLP-1RAs for 1 to 3 years was associated with an increased risk of all thyroid cancers (adjusted HR, 1.78; 95% CI 1.04–3.05) [29].”
InfluentialCheng, Z., Wang, S., Li, F., Jin, C., Mo, C., Zheng, J., Li, X., Liang, F., Yang, J.-K., & Gu, D. (2024) · Journal of Diabetes · doi:10.1111/1753-0407.70013 · Cited by 9
“Moreover, real-world studies from the Food and Drug Administration Adverse Event Reporting System also reported significantly increased reports ratios of thyroid cancer (proportional reporting ratio, PRR: 27.43) and papillary thyroid cancer (PRR: 8.68) 44,45 associated with GLP-1 RAs and DDP4i use.”
BackgroundInfluentialJaradat, J. H., Alahmad, R., Jaghbeer, M. A., Abdelaziz, A. A., Afifeh, N. A., Afifeh, G. A., Rao, A., Alzoubi, A., & Nashwan, A. J. (2025) · Cureus · doi:10.7759/cureus.96071 · Cited by 1
Barseghyan, L., Munir, I., Chrysafides, S., Simental, A., & Khan, S. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15207834
“This finding generated published discussion concerning residual confounding and detection bias [44–46], which the original authors addressed in a formal response [47].”
Metadata
- Authors
- Bezin, J., Mathieu, C., Faillie, J.-L., & Pariente, A.
- Affiliations
- Université de Bordeaux (FR)
- Inserm (FR)
- Corresponding author
- Bezin, Julien
- Venue
- Diabetes Care
- Publisher
- American Diabetes Association
- Published
- 2023-04-26
- Volume
- 46
- Issue
- 5
- Pages
- e121-e122
- ISSN
- 0149-5992 (ISSN-L)
- 1935-5548
- OpenAlex
- W4367060169
- Semantic Scholar
- 417113e2fbf280f1fafd534eeba33d33fb694830
- Cited by
- 7
- References
- 9
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 3 · 2023: 1
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Diabetes Care (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Oskar-Bordeaux (Universite de Bordeaux) (submittedVersion)
- Funders
- Agence Nationale de Sécurité du Médicament et des Produits de Santé (2019S015)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Cancer Diagnosis and Treatment
- Keywords
- GLP-1 receptor agonists, thyroid cancer, cancer risk, drug safety
- MeSH terms
- Glucagon-Like Peptide-1 Receptor, Glucagon-Like Peptide-1 Receptor Agonists, Diabetes Mellitus, Humans, Hypoglycemic Agents, Thyroid Neoplasms
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