Hydrochlorothiazide use and risk of nonmelanoma skin cancer: A nationwide case-control study from Denmark

Sidsel Arnspang, David Gaist, Sigrun Alba Johannesdottir Schmidt, Lisbet Rosenkrantz Hölmich, Søren Friis, Anton Pottegård

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Resumé

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.

OriginalsprogEngelsk
TidsskriftJournal of the American Academy of Dermatology
Vol/bind78
Udgave nummer4
Sider (fra-til)673-681.e9
ISSN0190-9622
DOI
StatusUdgivet - apr. 2018

Fingeraftryk

Skin Neoplasms
Denmark
Case-Control Studies
Confidence Intervals
Odds Ratio
Registries
Lip Neoplasms
Prescriptions
Logistic Models

Bibliografisk note

Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

Citer dette

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title = "Hydrochlorothiazide use and risk of nonmelanoma skin cancer: A nationwide case-control study from Denmark",
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.",
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author = "Sidsel Arnspang and David Gaist and {Johannesdottir Schmidt}, {Sigrun Alba} and H{\"o}lmich, {Lisbet Rosenkrantz} and S{\o}ren Friis and Anton Potteg{\aa}rd",
note = "Copyright {\circledC} 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.",
year = "2018",
month = "4",
doi = "10.1016/j.jaad.2017.11.042",
language = "English",
volume = "78",
pages = "673--681.e9",
journal = "American Academy of Dermatology. Journal",
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Hydrochlorothiazide use and risk of nonmelanoma skin cancer : A nationwide case-control study from Denmark. / Arnspang, Sidsel; Gaist, David; Johannesdottir Schmidt, Sigrun Alba; Hölmich, Lisbet Rosenkrantz; Friis, Søren; Pottegård, Anton.

I: Journal of the American Academy of Dermatology, Bind 78, Nr. 4, 04.2018, s. 673-681.e9.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Hydrochlorothiazide use and risk of nonmelanoma skin cancer

T2 - A nationwide case-control study from Denmark

AU - Arnspang, Sidsel

AU - Gaist, David

AU - Johannesdottir Schmidt, Sigrun Alba

AU - Hölmich, Lisbet Rosenkrantz

AU - Friis, Søren

AU - Pottegård, Anton

N1 - Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

PY - 2018/4

Y1 - 2018/4

N2 - 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.

AB - 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.

KW - Journal Article

KW - antihypertensives

KW - skin cancer

KW - hydrochlorothiazide

KW - pharmacology

KW - cancer risk

KW - nonmelanoma skin cancer

KW - pharmacoepidemiology

KW - Carcinoma, Basal Cell/chemically induced

KW - Hydrochlorothiazide/adverse effects

KW - Risk Assessment

KW - Humans

KW - Middle Aged

KW - Male

KW - Skin Neoplasms/chemically induced

KW - Case-Control Studies

KW - Denmark/epidemiology

KW - Carcinoma, Squamous Cell/chemically induced

KW - Aged, 80 and over

KW - Female

KW - Aged

KW - Antihypertensive Agents/adverse effects

U2 - 10.1016/j.jaad.2017.11.042

DO - 10.1016/j.jaad.2017.11.042

M3 - Journal article

C2 - 29217346

VL - 78

SP - 673-681.e9

JO - American Academy of Dermatology. Journal

JF - American Academy of Dermatology. Journal

SN - 0190-9622

IS - 4

ER -