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Individual SGLT-2 Inhibitors and Risk of New-Onset Cancer in Type 2 Diabetes: A Nationwide Population-Based Cohort
Hayeon Kim1, Jun-Ho Seo2,3, Jin Hyun Nam4
1College of Pharmacy, Korea University, Sejong, Korea.
Cancer Research and Treatment
|June 24, 2026
Summary
Sodium-glucose cotransporter-2 inhibitors (SGLT-2is), like empagliflozin and dapagliflozin, did not significantly alter new-onset cancer risk in type 2 diabetes patients. This real-world data suggests SGLT-2 inhibitors do not increase cancer incidence in this population.
Area of Science:
- Endocrinology
- Oncology
- Pharmacology
Background:
- Preclinical data suggested potential cancer-preventive effects of SGLT-2 inhibitors.
- Clinical evidence regarding SGLT-2 inhibitors and cancer risk in type 2 diabetes patients remains inconclusive.
- This study addresses the need for clinical data on SGLT-2 inhibitors (empagliflozin, dapagliflozin) and cancer incidence.
Purpose of the Study:
- To evaluate the association between SGLT-2 inhibitor use (empagliflozin or dapagliflozin) and new-onset cancer incidence.
- To compare cancer risk between SGLT-2 inhibitor users and users of other glucose-lowering drugs in type 2 diabetes patients.
- To investigate the incidence of site-specific cancers in relation to SGLT-2 inhibitor use.
Main Methods:
- Nationwide retrospective cohort study utilizing Korean national health claims data (2016-2019).
- Inclusion of type 2 diabetes patients initiating empagliflozin, dapagliflozin, or other glucose-lowering drugs (oGLDs).
- Propensity score matching was employed to create comparable cohorts; Cox proportional hazards models were used to estimate adjusted hazard ratios (HRs) and confidence intervals (CIs).
Main Results:
- After propensity score matching, 20,456 patients were in each group (SGLT-2i users vs. oGLDs users).
- No significant difference in overall cancer incidence was observed for empagliflozin (aHR 0.85, 95% CI 0.65-1.12) or dapagliflozin (aHR 0.87, 95% CI 0.66-1.14) compared to oGLDs.
- Incidence of site-specific cancers and comparisons between empagliflozin and dapagliflozin users also showed no significant differences, consistent across subgroup and sensitivity analyses.
Conclusions:
- Empagliflozin and dapagliflozin use was not associated with a significant difference in new-onset cancer incidence in patients with type 2 diabetes.
- These real-world findings provide clinical evidence regarding SGLT-2 inhibitor use and cancer risk in this patient population.
- Further long-term follow-up studies are recommended to strengthen the validity of these results.
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