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Does hydrochlorothiazide use increase risk of non-melanoma skin cancer?
[2 min read] Hydrochlorothiazide is photosensitising and has previously been linked to lip cancer. The drug is commonly used in Australia to treat hypertension and oedema, and is one of the most frequently used diuretic and anti-hypertensive drugs in the United States and Western Europe.
A Danish study looked at the association between hydrochlorothiazide use and the risk of basal cell carcinoma and squamous cell carcinoma.
The study found that high use of hydrochlorothiazide (≥50,000 mg) was associated with odds ratios of 1.29 (95% confidence interval [CI], 1.23-1.35) for basal cell carcinoma and 3.98 (95% CI, 3.68-4.31) for squamous cell carcinoma.
It found clear dose-response relationships between hydrochlorothiazide use and both basal cell and squamous cell carcinomas. The highest cumulative dose category (≥200,000 mg) had odds ratios of 1.54 (95% CI, 1.38-1.71) and 7.38 (95% CI, 6.32-8.60) for basal cell carcinoma and squamous cell carcinoma, respectively. Use of other diuretics and anti-hypertensives was not associated with non-melanoma skin cancer.
The study concluded that hydrochlorothiazide use is associated with a substantially increased risk of non-melanoma skin cancer, especially squamous cell carcinoma.
Pedersen, Sidsel Arnspang et al. Hydrochlorothiazide use and risk of nonmelanoma skin cancer: A nationwide case-control study from Denmark. Journal of the American Academy of Dermatology, Volume 78, Issue 4, 673 – 681.e9
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