Independent association of chronic kidney disease and cancer with long-term hospitalization and mortality among patients with type 2 diabetes. This study investigated the association between diabetic nephropathy and risk of incident cancers and associated long-term hospitalization and mortality in Taiwan. A total of 18,844 patients with type 2 diabetes without history of cancer were identified between January 1, 2000 and December 31, 2007. For this cohort study, they were categorized according to baseline serum creatinine level into four groups: <1.0 mg/dL, 1.0-1.4 mg/dL, 1.5-1.9 mg/dL, and ≥2.0 mg/dL, to represent the stages of increasing renal impairment. Cancer outcomes were assessed through December 31, 2012. There was a significant dose-response relationship between decline of eGFR and increased risk of cancer [ORs (95% CI): 1.06 (0.98-1.14), 1.10 (1.01-1.20), and 1.29 (1.15-1.46) for 1.0-1.4, 1.5-1.9, and ≥2.0 mg/dL, respectively], when compared with patients without renal impairment after controlling for age, gender, smoking, alcohol use, baseline eGFR, hypertension, cerebrovascular disease, peripheral arterial disease, and use of renin-angiotensin system inhibitor, as well as other potential confounders. Further, subjects with diabetic nephropathy had a two-fold higher risk of mortality than patients without this condition (adjusted HR, 1.97; 95% CI 1.49-2.61). Patients with diabetic nephropathy who developed cancer had a significantly higher risk of rehospitalization (HR, 2.27; 95% CI 1.82-2.84). In conclusion, we found a significant dose-response relationship between decline of eGFR and increased risk of incident cancers and subsequent mortality in patients with type 2 diabetes. These findings need to be confirmed with further study.