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Hydrochlorothiazide increases risk of nonmelanoma skin cancer

24 Mar 2018

Hydrochlorothiazide (HCTZ) use appears to significantly increase the risk of nonmelanoma skin cancer (NMSC), particularly squamous cell carcinomas (SCC), a recent Danish study has shown.

Using the national prescription registry, researchers assessed the cumulative HCTZ use in 80,162 patients with NMSC. Controls were enrolled at a 1:20 ratio and matched by age and sex. Conditional logistic regression was used to determine the risk of SCC and basal cell carcinoma (BCC).

Of the participants, majority had BCC (n=71,533) while the rest had SCC (n=8,629). The corresponding population control groups included 1,430,883 and 172,462 individuals, respectively.

High HCTZ use (≥50,000 mg) was reported in 10 percent of the SCC patients and in 2.8 percent of the corresponding control group. This resulted in a significantly higher risk in the fully-adjusted model (odds ratio [OR], 3.98; 95 percent CI, 3.68–4.31).

HCTZ use also showed a dose-response relationship with SCC development, such that those with 200,000 mg of cumulative intake had significantly higher risks than those with lower cumulative use (OR, 7.38; 6.32–8.60; p<0.001 for trend).

The same trends were observed with BCC, but to a lesser degree: high MCTZ use was associated with a significantly higher risk of BCC (OR, 1.29; 1.23–1.35). Cumulative use of 200,000 mg also led to a significantly elevated BCC risk (OR, 1.54; 1.38–1.71; p<0.001 for trend).

“The use of HCTZ should be carefully considered, as several other antihypertensive agents with similar indications and efficiency are available, but without known associations with skin cancer,” said researchers.

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