Hydrochlorothiazide use and risk of nonmelanoma skin cancer: A nationwide case-control study from Denmark
Hydrochlorothiazide use and risk of nonmelanoma skin cancer: A nationwide case-control study from Denmark
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DOI：
10.1016/j.jaad.2017.11.042
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发表时间：
2018-04-01
影响因子：
13.8
通讯作者：
Pottegard, Anton
中科院分区：
文献类型：
--
作者：
Pedersen, Sidsel Arnspang;Gaist, David;Pottegard, Anton
背景资料：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，以前曾被认为与唇癌有关。目的：研究氢氯噻嗪使用与基底细胞癌（BCC）和鳞状细胞癌（SCC）风险之间的关系。从丹麦癌症登记处，我们确定了2004-2012年期间患有非黑色素瘤皮肤癌（NMSC）的患者（病例）。对照组按年龄和性别1：20配对。从丹麦处方登记处评估了氢氯噻嗪的累积使用（1995-2012年）。使用条件Logistic回归，我们计算了BCC和SCC与氢氯噻嗪使用相关的比值比（OR）。结果：氢氯噻嗪的大量使用（>= 50，000 mg）与BCC的OR为1.29（95%置信区间[ CI]，1.23-1.35）和SCC的OR为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之间存在明确的剂量反应关系;最高累积剂量类别（>= 200，000 mg HCTZ）的BCC和SCC 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.Limitations：No data on sun exposure were available.Conclusions：氢氯噻嗪的使用与NMSC的风险大幅增加相关，尤其是SCC。（J Am Acad Dermatol 2018; 78：673-81。）
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. (J Am Acad Dermatol 2018; 78: 673-81.)