Hydrochlorothiazide use and risk for Merkel cell carcinoma and malignant adnexal skin tumors: A nationwide case-control study

Sidsel Arnspang Pedersen, Sigrun Alba Johannesdottir Schmidt, Lisbet Rosenkrantz Hölmich, Søren Friis, Anton Pottegård, David Gaist

33 Citations (Scopus)

Abstract

BACKGROUND: Hydrochlorothiazide use has been associated with markedly increased risk for squamous cell carcinoma. No previous studies have investigated the association between hydrochlorothiazide use and the risk for Merkel cell carcinoma (MCC) and malignant adnexal skin tumors (MAST).

OBJECTIVE: To examine the association between hydrochlorothiazide use and the risk for MCC and MAST.

METHODS: Using Danish nationwide health registries, we identified all patients with incident MCC or MAST during 2004-2015 and matched the cases individually to cancer-free population controls by risk set sampling. Using conditional logistic regression, we estimated the odds ratios (ORs) and confidence intervals (CIs) associated with cumulative use of hydrochlorothiazide.

RESULTS: The adjusted ORs for MCC and MAST associated with high use (≥50,000 mg) of hydrochlorothiazide was 2.3 (95% CI 1.1-4.8) and 3.6 (95% CI 1.9-7.0), respectively, which increased to 3.3 (95% CI 1.3-8.3) and 5.6 (95% CI 2.4-13.3), respectively, with highest use (≥100,000 mg). We found no increased risk for these tumors in analyses of drugs with similar indications as hydrochlorothiazide, except there was a tendency toward an increased risk for MCC associated with the use of furosemide (OR 1.9, 95% CI 0.9-4.0).

LIMITATIONS: No data on sun exposure was available.

CONCLUSION: Hydrochlorothiazide use is associated with an increased risk for MCC and MAST.

Original languageEnglish
JournalJournal of the American Academy of Dermatology
Volume80
Issue number2
Pages (from-to)460-465.e9
Number of pages6
ISSN0190-9622
DOIs
Publication statusPublished - 15 Feb 2019

Keywords

  • antihypertensives
  • epidemiology
  • hydrochlorothiazide
  • malignant adnexal skin tumors
  • Merkel cell carcinoma
  • pharmacology
  • skin cancer

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