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

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

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

METHODS: Using Danish nationwide health registries, we identified all patients with incident MCC or MAST during 2004-2015 and matched cases individually to cancer-free population controls by risk set sampling. Using conditional logistic regression, we estimated odds ratios (ORs) 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, increasing to 3.3 (95% CI 1.3-8.3) and 5.6 (95% CI 2.4-13.3) with highest use (≥100,000mg). We found no increase in risk of the tumors in analyses of drugs with similar indications as hydrochlorothiazide, except a tendency toward an increased risk of MCC associated with use of furosemide (OR 1.9, 95% CI 0.9-4.0).

LIMITATIONS: No data on sun exposure was available.

CONCLUSIONS: Hydrochlorothiazide use is associated with an increased risk of MCC and MAST.

LanguageEnglish
JournalJournal of the American Academy of Dermatology
ISSN0190-9622
DOIs
StateE-pub ahead of print - 15 Jun 2018