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. 2024 Nov;33(11):e70027.
doi: 10.1002/pds.70027.

Hydrochlorothiazide Use and Risk of Skin Cancer: A Population-Based Retrospective Cohort Study

Avery Shuei-He Yang  1 , Leila Djebarri  2 , Chaw Ning Lee  1   3 , Denis Granados  2 , Mohamed Abdel Moneim  4 , Shih-Chieh Shao  1   5 , Swu-Jane Lin  6 , Tzu-Chi Liao  1 , Hung-Wei Lin  7 , Edward Chia-Cheng Lai  1
Affiliations

Hydrochlorothiazide Use and Risk of Skin Cancer: A Population-Based Retrospective Cohort Study

Avery Shuei-He Yang et al. Pharmacoepidemiol Drug Saf. 2024 Nov.

Abstract

Purpose: Hydrochlorothiazide (HCTZ) exposure has been linked to increased skin cancer in Caucasian (white) populations, especially squamous cell carcinoma (SCC), but not basal cell carcinoma (BCC). This study aimed to evaluate and compare skin cancer risks associated with HCTZ- and other antihypertensives use.

Methods: This retrospective cohort study utilized Taiwan's National Health Insurance Research Database. We identified patients aged 20 years and older, newly receiving antihypertensive medications between 2004 and 2015. We calculated the medication possession ratio (MPR) for the first 2 years of treatment to determine patient eligibility and treatment classification, whereby only patients with MPR above 80% were included. These were subsequently categorized by the type of antihypertensives they received, namely HCTZ, other thiazide diuretics, non-thiazide diuretics or non-diuretic antihypertensives. Cox proportional hazards model was used to evaluate skin cancer risks, and these were then classified as SCC or BCC.

Results: Our study included 41 086, 27 402, 19 613, and 856 782 patients receiving HCTZ, other thiazide diuretics, non-thiazide diuretics, and non-diuretic antihypertensives, respectively. We found BCC risks were similar when comparing HCTZ with other thiazides (adjusted hazard ratio: 0.84; 95% CI: 0.54-1.33), non-thiazide diuretics (0.93; 0.51-1.67), and non-diuretic antihypertensives (0.91; 0.66-1.26). We observed a higher SCC risk in the HCTZ group, compared to other thiazides (1.24; 0.74-2.08), non-thiazide diuretics (1.32; 0.70-2.51), and non-diuretic antihypertensives (1.23; 0.87-1.73), although the confidence intervals (CIs) were wide and crossed the null.

Conclusions: We concluded that skin cancer need not be of major concern to physicians when prescribing antihypertensives for an Asian population.

Keywords: antihypertensive agent; basal cell carcinoma and squamous cell carcinoma; hydrochlorothiazide; non‐melanoma skin cancer.

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References

    1. K. Urban, S. Mehrmal, P. Uppal, R. L. Giesey, and G. R. Delost, “The Global Burden of Skin Cancer: A Longitudinal Analysis From the Global Burden of Disease Study, 1990–2017,” JAAD International 2 (2021): 98–108.
    1. M. A. O'Leary and S. J. Wang, “Epidemiology and Prevention of Cutaneous Cancer,” Otolaryngologic Clinics of North America 54, no. 2 (2021): 247–257.
    1. P. Aggarwal, P. Knabel, and A. B. Fleischer, Jr., “United States Burden of Melanoma and Non‐Melanoma Skin Cancer From 1990 to 2019,” Journal of the American Academy of Dermatology 85, no. 2 (2021): 388–395.
    1. C. C. Oh, A. Jin, and W. P. Koh, “Trends of Cutaneous Basal Cell Carcinoma, Squamous Cell Carcinoma, and Melanoma Among the Chinese, Malays, and Indians in Singapore From 1968–2016,” JAAD International 4 (2021): 39–45.
    1. K. Orthaber, M. Pristovnik, K. Skok, B. Perić, and U. Maver, “Skin Cancer and Its Treatment: Novel Treatment Approaches With Emphasis on Nanotechnology,” Journal of Nanomaterials 2017 (2017): 1–20.

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