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.

中文翻译：

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氢氯噻嗪的使用和非黑色素瘤皮肤癌的风险：来自丹麦的全国性病例对照研究。

背景

氢氯噻嗪是美国和西欧最常用的利尿剂和抗高血压药物之一，具有光敏性，以前曾与唇癌有关。

客观的

研究氢氯噻嗪的使用与基底细胞癌 (BCC) 和鳞状细胞癌 (SCC) 风险之间的关联。

方法

从丹麦癌症登记处，我们确定了 2004 年至 2012 年期间患有非黑色素瘤皮肤癌 (NMSC) 的患者（病例）。对照按年龄和性别按 1:20 匹配。丹麦处方登记处评估了氢氯噻嗪的累积使用情况（1995-2012 年）。使用条件逻辑回归，我们计算了与使用氢氯噻嗪相关的 BCC 和 SCC 的优势比 (OR)。

结果

大量使用氢氯噻嗪（≥50,000 mg）与 BCC 的 OR 为 1.29（95% 置信区间 [CI]，1.23-1.35）和 SCC 的 3.98（95% CI，3.68-4.31）相关。我们发现氢氯噻嗪的使用与 BCC 和 SCC 之间存在明显的剂量反应关系；对于 BCC 和 SCC，最高累积剂量类别（≥200,000 mg HCTZ）的 OR 分别为 1.54（95% CI，1.38-1.71）和 7.38（95% CI，6.32-8.60）。使用其他利尿剂和抗高血压药与 NMSC 无关。

限制

没有关于阳光照射的数据。

结论

氢氯噻嗪的使用与 NMSC，尤其是 SCC 的风险显着增加有关。