Preclinical research suggests sodium-glucose cotransporter 2 inhibitors possess anticancer effects beyond metabolic benefits. Doctors need data on real-world cancer risk reduction in diabetes patients. 
In a study published in the Diabetes and Metabolism Journal, the researchers studied 45,601 new SGLT2i users and 205,395 new users of other glucose-lowering medications from September 2014 to June 2020. They used a nationwide database for this active-comparator new-user design. Propensity score matching created balanced cohorts of 35,371 patients in each group. 
Lower Incidence Confirmed in Large Cohort
Prostate cancer occurred in 210 of 45,601 SGLT2i users. This gave 1.0% cumulative incidence. Other glucose-lowering medications showed 1,880 cases in 205,395 users. Their incidence reached 1.5%. Multivariable adjustment found SGLT2i use lowered risk. The hazard ratio was 0.83 with 95% CI 0.71 to 0.98.
Propensity Matching Strengthens Findings
Propensity score matched analysis confirmed results. SGLT2i associated with 18% prostate cancer risk reduction. Hazard ratio was 0.82 with 95% CI 0.67 to 0.99. Matching balanced age, comorbidities, and medication history.
BMI Modifies Protective Effect
Subgroup analysis showed body mass index influences benefit. Patients with BMI <25 kg/m2 gained most protection. Interaction P-value was 0.037. Leaner patients showed stronger risk reduction.
Clinical Implications for Diabetes Care
Endocrinologists and oncologists should note SGLT2i cancer prevention potential. These drugs already reduce heart failure and kidney disease in T2DM. Prostate cancer risk reduction adds value. Consider SGLT2i preference in male T2DM patients with elevated PSA or family history. Lean BMI patients may benefit most. Long-term studies needed to confirm mechanisms.