Thyroid surveillance practices in GLP-1 receptor agonist use and its potential influence on thyroid cancer detection:...

Rodent data prompted a boxed warning for medullary thyroid carcinoma (MTC) with glucagon-like peptide-1 receptor agonists (GLP-1RAs), yet human findings remain inconsistent and may reflect how intensively patients are screened. We mapped reported thyroid screening practices and detection bias reporting. Following JBI methodology and PRISMA-ScR reporting guidance, we searched PubMed, Scopus, Embase, CENTRAL, and ClinicalTrials.gov from 2010 to July 2026. Empirical studies and trial registry records reporting thyroid screening in adult GLP-1RA users were eligible. Records were charted and synthesised descriptively. Thirty-nine records were included (29 published studies, 10 registry records). Screening was predominantly biochemical. Calcitonin was reported in 16/29 studies (55.2%) and all registry records, whereas ultrasonography was reported in 13/29 (44.8%) and no trials. 19/29 studies (65.5%) described a screening protocol. Screening intensity was reported in 18/29(62.1%) but detection bias in 11/29 (37.9%). All registry records excluded personal or family history of MTC or multiple endocrine neoplasia type 2 before screening. Thyroid screening in GLP-1RA users is heterogeneous, calcitonin-centred, and inconsistently reported, while patients at highest C-cell risk are excluded from trials. Detection bias is seldom addressed despite documented increases in imaging. Standardised reporting of screening intensity is needed to interpret thyroid cancer rates.