학술논문
Hydrochlorothiazide use and risk of keratinocyte carcinoma and melanoma: A multisite population-based cohort study.
Document Type
Academic Journal
Author
Azoulay L; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Gerald Bronfman Department of Oncology, McGill University, Montreal, Quebec, Canada; Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada. Electronic address: laurent.azoulay@mcgill.ca.; St-Jean A; Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.; Dahl M; Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada.; Quail J; Health Quality Council, Saskatoon, Saskatchewan, Canada.; Aibibula W; Complete HEOR Solutions, Montreal, Quebec, Canada.; Brophy JM; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada; Department of Medicine, McGill University, Montreal, Quebec, Canada.; Chan AW; Division of Dermatology, Department of Medicine, Women's College Research Institute, University of Toronto, Toronto, Ontario, Canada; ICES, Toronto, Ontario, Canada.; Bresee L; Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.; Carney G; Department of Anesthesiology, Pharmacology and Therapeutics, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.; Eltonsy S; College of Pharmacy, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.; Tamim H; School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada; Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada.; Paterson JM; ICES, Toronto, Ontario, Canada.; Platt RW; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada; Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada; Department of Pediatrics, McGill University, Montreal, Quebec, Canada.
Source
Publisher: Mosby Country of Publication: United States NLM ID: 7907132 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1097-6787 (Electronic) Linking ISSN: 01909622 NLM ISO Abbreviation: J Am Acad Dermatol Subsets: MEDLINE
Subject
Language
English
Abstract
Background: The association between hydrochlorothiazide (HCTZ) and skin cancer remains controversial.
Objective: To determine whether HCTZ is associated with an increased risk of skin cancer compared with angiotensin-converting enzyme inhibitors and calcium channel blockers.
Methods: Two new-user, active comparator cohorts were assembled using 6 Canadian databases. Site-specific hazard ratios (HRs) with 95% CIs were estimated using standardized morbidity ratio weighted Cox proportional hazard models and pooled using random-effects meta-analysis.
Results: HCTZ was not associated with an overall increased risk of keratinocyte carcinoma compared with angiotensin-converting enzyme inhibitors or calcium channel blockers, although increased risks were observed with longer durations (≥10 years; HR: 1.12; 95% CI: 1.03-1.21) and higher cumulative doses (≥100,000 mg; HR: 1.49; 95% CI: 1.27-1.76). For melanoma, there was no association with angiotensin-converting enzyme inhibitors, but a 32% increased risk with calcium channel blockers (crude incidence rates: 64.2 vs 58.4 per 100,000 person-years; HR: 1.32; 95% CI: 1.19-1.46; estimated number needed to harm at 5 years of follow-up: 1627 patients), with increased risks with longer durations and cumulative doses.
Limitations: Residual confounding due to the observational design.
Conclusions: Increased risks of keratinocyte carcinoma and melanoma were observed with longer durations of use and higher cumulative doses of HCTZ.
Competing Interests: Conflicts of interest Dr Azoulay received speaker fees from Janssen, Pfizer, and Roche for work unrelated to this study. Dr Platt received consulting fees from Biogen, Boehringer Ingelheim, Merck, Nant Pharma, and Pfizer for work unrelated to this study. Dr Abibula conducted this research during his employment as Staff Scientist at the Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital prior to his employment at Complete HEOR Solutions. Authors St-Jean and Dahl; and Drs Quail, Brophy, Chan, Bresee, Carney, Eltonsy, and Tamim have no conflicts of interest to declare.
(Copyright © 2023 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)
Objective: To determine whether HCTZ is associated with an increased risk of skin cancer compared with angiotensin-converting enzyme inhibitors and calcium channel blockers.
Methods: Two new-user, active comparator cohorts were assembled using 6 Canadian databases. Site-specific hazard ratios (HRs) with 95% CIs were estimated using standardized morbidity ratio weighted Cox proportional hazard models and pooled using random-effects meta-analysis.
Results: HCTZ was not associated with an overall increased risk of keratinocyte carcinoma compared with angiotensin-converting enzyme inhibitors or calcium channel blockers, although increased risks were observed with longer durations (≥10 years; HR: 1.12; 95% CI: 1.03-1.21) and higher cumulative doses (≥100,000 mg; HR: 1.49; 95% CI: 1.27-1.76). For melanoma, there was no association with angiotensin-converting enzyme inhibitors, but a 32% increased risk with calcium channel blockers (crude incidence rates: 64.2 vs 58.4 per 100,000 person-years; HR: 1.32; 95% CI: 1.19-1.46; estimated number needed to harm at 5 years of follow-up: 1627 patients), with increased risks with longer durations and cumulative doses.
Limitations: Residual confounding due to the observational design.
Conclusions: Increased risks of keratinocyte carcinoma and melanoma were observed with longer durations of use and higher cumulative doses of HCTZ.
Competing Interests: Conflicts of interest Dr Azoulay received speaker fees from Janssen, Pfizer, and Roche for work unrelated to this study. Dr Platt received consulting fees from Biogen, Boehringer Ingelheim, Merck, Nant Pharma, and Pfizer for work unrelated to this study. Dr Abibula conducted this research during his employment as Staff Scientist at the Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital prior to his employment at Complete HEOR Solutions. Authors St-Jean and Dahl; and Drs Quail, Brophy, Chan, Bresee, Carney, Eltonsy, and Tamim have no conflicts of interest to declare.
(Copyright © 2023 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.)