Objective:

To investigate the association between sodium-glucose cotransporter 2 (SGLT2) inhibitors and the incidence of kidney cancer in patients with type 2 diabetes, highlighting its significance in diabetes management.

Key Findings:

• SGLT2 inhibitor users had 38 kidney cancer events (incidence rate of 18.9 per 100,000 person-years) compared to 64 events in DPP-4 users (30.8 per 100,000 person-years), totaling 102 events.
• SGLT2 inhibitor use was associated with a 40% lower hazard of kidney cancer (hazard ratio 0.60, 95% CI 0.40 to 0.89).
• The association remained consistent across various subgroups and sensitivity analyses.

Interpretation:

The findings suggest a potential association between SGLT2 inhibitor use and lower kidney cancer risk, with implications for clinical practice, but further validation is needed.

Limitations:

• Observational design may introduce residual confounding.
• Short follow-up period may not capture all kidney cancer cases.
• Lack of tumor pathology data prevents subtype analysis.
• Generalizability may be limited to Korean patients.

Conclusion:

The study indicates a lower incidence of kidney cancer among SGLT2 inhibitor users compared to DPP-4 inhibitor users, warranting further research to confirm these findings.