Skin Cancer and Hydrochlorothiazide: Novel Population-Based Analyses Considering Personal Risk Factors Including...

Area of Science:

• Dermatology
• Pharmacology
• Epidemiology

Background:

• Hydrochlorothiazide (HCTZ), a widely used antihypertensive medication, possesses photosensitive properties.
• These photosensitive properties raise concerns about a potential increased risk of skin cancer among HCTZ users.
• This study investigates the association between HCTZ use and the risk of developing melanoma and nonmelanoma skin cancer.

Purpose of the Study:

• To evaluate the risk of melanoma and nonmelanoma skin cancer in individuals using hydrochlorothiazide.
• To compare this risk against users of angiotensin-converting enzyme (ACE) inhibitors as an active comparator.
• To assess potential confounding factors and effect modifiers, including race/ethnicity, across three distinct cohorts.

Main Methods:

• Three large cohorts were constructed from IBM MarketScan Research Databases: Commercial and Encounters, a health risk assessment subcohort, and Medicaid.
• Adults initiating hydrochlorothiazide or ACE inhibitors, with at least 12 months of prior enrollment, were included.
• Multivariate proportional hazards regression was employed to compare skin cancer risk between hydrochlorothiazide and ACE inhibitor users, adjusting for covariates.

Main Results:

• Baseline characteristics were largely similar between groups, though hydrochlorothiazide users had a higher proportion of Black individuals.
• Hazard ratios for nonmelanoma skin cancer associated with hydrochlorothiazide versus ACE inhibitors were 0.96 (Commercial), 1.01 (HRA subcohort), and 1.33 (Medicaid).
• Hazard ratios for melanoma were 1.07 (Commercial), 0.85 (HRA subcohort), and 0.93 (Medicaid).

Conclusions:

• The study utilized three distinct cohort approaches to investigate the relationship between hydrochlorothiazide and skin cancer risk.
• Adjustments for potential confounders, including race/ethnicity, were incorporated into the analyses.
• No clear difference in skin cancer risk was established between hydrochlorothiazide and ACE inhibitor use across the evaluated cohorts.