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Use of hydrochlorothiazide and risk of skin cancer: a nationwide Taiwanese case-control study

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  • Anton Pottegård, Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark. mmhellfritzsch@health.sdu.dk.
  • ,
  • Sidsel Arnspang Pedersen, The Danish Aging Research Center, and The Danish Twin Registry, Institute of Public Health, University of Southern Denmark, Odense, Denmark; Department of Clinical Genetics, Odense University Hospital, Odense, Denmark; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark.
  • ,
  • Sigrun Alba Johannesdottir Schmidt
  • Chaw-Ning Lee, Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
  • ,
  • Chao-Kai Hsu, Department of Dermatology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
  • ,
  • Tzu-Chi Liao, School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
  • ,
  • Shih-Chieh Shao, Department of Pharmacy, Chang Gung Memorial Hospital, Keelung, Taiwan.
  • ,
  • Edward Chia-Cheng Lai, Department of Pharmacy, National Cheng Kung University Hospital, Tainan, Taiwan. edward_lai@mail.ncku.edu.tw.

BACKGROUND: The antihypertensive agent hydrochlorothiazide has been associated with increased risks of non-melanoma skin cancer (NMSC) and possibly some melanoma subtypes. Previous studies were, however, conducted in predominantly Caucasian populations. We therefore examined the association between hydrochlorothiazide and skin cancer risk in an Asian population.

METHODS: By using Taiwan's National Health Insurance Research Database (NHIRD), we conducted three separate case-control studies of lip cancer, non-lip non-melanoma skin cancer and melanoma. Cases (n = 29,082) with a first-ever skin cancer diagnoses (2008-2015) were matched 1:10 to population controls. We estimated odds ratios (ORs) associating hydrochlorothiazide use with skin cancer risk by using conditional logistic regression.

RESULTS: Hydrochlorothiazide use showed no overall association with any of the three outcomes: ORs for high cumulative use of HCTZ (≥50,000 mg) were 0.86 (95% CI 0.09-7.81) for lip cancer, 1.16 (95% CI 0.98-1.37) for non-lip NMSC and 1.07 (95% CI 0.65-1.76) for melanoma. There was some evidence of a dose-response pattern for non-lip NMSC, with an OR of 1.66 (95% CI 0.82-3.33) for 100,000-149,999 mg of HCTZ. The null findings were robust across subgroup and sensitivity analyses.

CONCLUSION: Use of HCTZ appears safe in terms of skin cancer risk in an Asian population.

Original languageEnglish
JournalBritish Journal of Cancer
Volume121
Pages (from-to)973-978
Number of pages6
ISSN0007-0920
DOIs
Publication statusPublished - 2019

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