Hydrochlorothiazide use and risk of nonmelanoma skin cancer: A nationwide case-control study from Denmark - 14/03/18
Abstract |
Background |
Hydrochlorothiazide, one of the most frequently used diuretic and antihypertensive drugs in the United States and Western Europe, is photosensitizing and has previously been linked to lip cancer.
Objective |
To examine the association between hydrochlorothiazide use and the risk of basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
Methods |
From the Danish Cancer Registry, we identified patients (cases) with nonmelanoma skin cancer (NMSC) during 2004-2012. Controls were matched 1:20 by age and sex. Cumulative hydrochlorothiazide use (in 1995-2012) was assessed from the Danish Prescription Registry. Using conditional logistic regression, we calculated odds ratios (ORs) for BCC and SCC associated with hydrochlorothiazide use.
Results |
High use of hydrochlorothiazide (≥50,000 mg) was associated with ORs of 1.29 (95% confidence interval [CI], 1.23-1.35) for BCC and 3.98 (95% CI, 3.68-4.31) for SCC. We found clear dose-response relationships between hydrochlorothiazide use and both BCC and SCC; the highest cumulative dose category (≥200,000 mg of HCTZ) had ORs of 1.54 (95% CI, 1.38-1.71) and 7.38 (95% CI, 6.32-8.60) for BCC and SCC, respectively. Use of other diuretics and antihypertensives was not associated with NMSC.
Limitations |
No data on sun exposure were available.
Conclusions |
Hydrochlorothiazide use is associated with a substantially increased risk of NMSC, especially SCC.
Le texte complet de cet article est disponible en PDF.Key words : antihypertensives, cancer risk, hydrochlorothiazide, nonmelanoma skin cancer, pharmacoepidemiology, pharmacology, skin cancer
Abbreviations used : BCC, CI, HCTZ, NMSC, OR, SCC, UV
Plan
Funding sources: Supported by a grant from the Danish Cancer Society (grant R72-A4417) and the Danish Council of Independent Research (grant 4004-00234B). The funding source had no role in the design of the study, data analysis, or interpretation of the results. |
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Disclosure: Dr Pottegård has participated in research projects unrelated to the present study and used grants provided by LEO Pharma (manufacturer of bendroflumethiazide) to the institution at which he was employed. Dr Gaist received honoraria from AstraZeneca (Sweden) for participating as a coinvestigator in a research project outside this work. Drs Pedersen, Schmidt, Hölmich, and Friis have no conflicts of interest to disclosed. |
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Reprints not available from the authors. |
Vol 78 - N° 4
P. 673 - avril 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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