SGLT-2 inhibitors reduce overall, lung, and thyroid cancer risk versus DPP-4i in T2DM.

Type 2 Diabetes Mellitus (T2DM) patients face an elevated risk of developing various cancers. While sodium-glucose cotransporter-2 inhibitors (SGLT-2i) are widely used for their glycemic control and established cardiovascular and renal benefits, their long-term impact on cancer risk has remained a subject of controversy. Current evidence is conflicting, leaving a critical gap in understanding whether SGLT-2i offer protective effects or pose risks regarding oncogenesis. Clarifying this association is crucial for comprehensive patient care and informing cancer prevention strategies in the T2DM population.

Researchers conducted an active-comparator, new-user cohort study using the Shenzhen Public Health Data Platform. They emulated a target trial comparing SGLT-2 inhibitors against two reference medications: Dipeptidyl peptidase-4 inhibitors (DPP-4i) and glucagon-like peptide-1 receptor agonists (GLP-1RA). The primary cohort, comparing SGLT-2i to DPP-4i, included 134,481 patients. Participants were followed for a median of 1.8 years, with cancer incidence as the primary endpoint. Overlapping weighting-based Cox proportional hazards models were used to assess hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for confounders.