Hydrochlorothiazide use is strongly associated with risk of lip cancer
Hydrochlorothiazide use is strongly associated with risk of lip cancer
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DOI：
10.1111/joim.12629
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发表时间：
2017-10-01
影响因子：
11.1
通讯作者：
Friis, S.
中科院分区：
文献类型：
--
作者：
Pottegard, A.;Hallas, J.;Friis, S.
背景利尿剂氢氯噻嗪是美国和西欧最常用的处方药之一，但有证据表明氢氯噻嗪的使用会增加唇癌的风险。研究氢氯噻嗪的使用与唇鳞状细胞癌的关系。我们使用丹麦全国登记数据进行了一项病例对照研究。从癌症登记处（2004-2012年），我们确定了633例唇鳞状细胞癌（SCC）患者，并使用风险集抽样策略将其与63067例人群对照进行匹配。氢氯噻嗪使用情况（1995-2012年）来自处方登记研究，并根据累积使用情况进行定义。应用条件Logistic回归，我们计算了SCC唇癌与氢氯噻嗪使用相关的优势比（OR），并对从人口统计学、处方和患者登记中获得的预定义的潜在混杂因素进行了调整。长期使用氢氯噻嗪与SCC唇癌的校正OR为2.1（95%置信区间（CI）：1.7-2.6）相关，高剂量使用（>= 25 000 mg）时增加至3.9（95% CI：3.0-4.9）。存在明显的剂量反应效应（P < 0.001），氢氯噻嗪的最高累积剂量类别（>= 100 000 mg）的OR为7.7（95% CI：5.7-10.5）。使用其他利尿剂或非利尿抗高血压药与唇癌无关。假设因果关系，我们估计11%的SCC唇癌病例可归因于氢氯噻嗪的使用。使用氢氯噻嗪与唇癌风险增加密切相关。
Background. The diuretic hydrochlorothiazide is amongst the most frequently prescribed drugs in the United States and Western Europe, but there is suggestive evidence that hydrochlorothiazide use increases the risk of lip cancer.Objectives. To study the association between use of hydrochlorothiazide and squamous cell carcinoma of the lip.Methods. We conducted a case-control study using Danish nationwide registry data. From the Cancer Registry (2004-2012), we identified 633 case patients with squamous cell carcinoma (SCC) of the lip and matched them to 63 067 population controls using a risk-set sampling strategy. Hydrochlorothiazide use (1995-2012) was obtained from the Prescription Registry and defined according to cumulative use. Applying conditional logistic regression, we calculated odds ratios (ORs) for SCC lip cancer associated with hydrochlorothiazide use, adjusting for predefined potential confounders obtained from demographic, prescription and patient registries.Results. Ever-use of hydrochlorothiazide was associated with an adjusted OR for SCC lip cancer of 2.1 (95% confidence interval (CI): 1.7-2.6), increasing to 3.9 (95% CI: 3.0-4.9) for high use (>= 25 000 mg). There was a clear dose-response effect (P < 0.001), with the highest cumulative dose category of hydrochlorothiazide (>= 100 000 mg) presenting an OR of 7.7 (95% CI: 5.7-10.5). No association with lip cancer was seen with use of other diuretics or nondiuretic antihypertensives. Assuming causality, we estimated that 11% of the SCC lip cancer cases could be attributed to hydrochlorothiazide use.Conclusions. Hydrochlorothiazide use is strongly associated with an increased risk of lip cancer.