Do Thiazide Diuretics Increase the Risk of Skin Cancer? A Critical Review of the Scientific Evidence and Updated Meta-Analysis

Bendinelli, Benedetta; Masala, Giovanna; Garamella, Giuseppe; Palli, Domenico; Caini, Saverio

doi:10.1007/s11886-019-1183-z

Cited by 22 publications

(28 citation statements)

References 40 publications

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“…The latest meta-analysis involving nine observational studies (Shin et al, 2019) found that the use of thiazide diuretics might be associated with an increased risk of skin cancer, especially with squamous cell carcinoma (adjusted odds ratio (aOR) 1.86; 95% CI 1.23-2.80). Bendinelli et al (Bendinelli et al, 2019) and Garrido et al (Garrido and Borges-Costa, 2020) also reached a consistent conclusion in this regard. According to a meta-analysis conducted by Gandini et al (Gandini et al, 2018) involving 77,622 cases, no association between thiazide diuretics, ACEIs, or ARBs and skin cancer risk was found, while CCBs and BBs were associated with an increased risk.…”

Section: Other Cancerssupporting

confidence: 58%

The Relationship Between Anti-Hypertensive Drugs and Cancer: Anxiety to be Resolved in Urgent

et al. 2020

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Hypertension is the prevailing independent risk factor for cardiovascular disease worldwide. Anti-hypertensive drugs are the common and effective cure for lowering blood pressure in patients with hypertension. However, some large-scale clinical studies have pointed out that long-term ingestion of some oral anti-hypertensive drugs was associated with risks of incident cancer and the survival time. In contrast, other studies argue that anti-hypertensive drugs are not related to the occurrence of cancer, even as a complementary therapy of tumor treatment. To resolve the dispute, numerous recent mechanistic studies using animal models have tried to find the causal link between cancer and different anti-hypertensive drugs. However, the results were often contradictory. Such uncertainties have taken a toll on hypertensive patients. In this review, we will summarize advances of longitudinal studies in the association between anti-hypertensive drugs and related tumor risks that have helped to move the field forward from associative to causative conclusions, in hope of providing a reference for more rigorous and evidence-based clinical research on the topic to guide the clinical decision making.

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Section: Other Cancerssupporting

confidence: 58%

The Relationship Between Anti-Hypertensive Drugs and Cancer: Anxiety to be Resolved in Urgent

et al. 2020

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“…Multiple meta-analyses [ 13 , 22 , 23 , 24 , 25 ] have investigated the relationship between use of diuretics, especially thiazide diuretics and skin cancer. The most recent meta-analysis found a small increased risk of BCC associated with thiazide use with summary relative risk (RR) of 1.17 (95% confidence interval [CI] 1.03–1.33), including two case-control studies, one matched cohort study and one cohort study [ 26 ]. The analysis for SCC (including five case-control studies, one matched cohort study and one RCT) found a stronger association (RR 1.93, 95% CI 1.59–2.35) with use of thiazide diuretics.…”

Section: Resultsmentioning

confidence: 99%

“…The meta-analysis also found that the RR of melanoma associated with thiazide diuretics use was 1.17 (95% CI 1.12–1.24), with a dose-response relationship based on three case-control studies and one matched cohort study [ 26 ]. The majority of included studies were based on Caucasian populations.…”

Section: Resultsmentioning

confidence: 99%

Photosensitizing Medications and Skin Cancer: A Comprehensive Review

George

Baranwal

Kang

et al. 2021

Cancers

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(1) The incidence of skin cancer is increasing in the United States (US) despite scientific advances in our understanding of skin cancer risk factors and treatments. In vitro and in vivo studies have provided evidence that suggests that certain photosensitizing medications (PSMs) increase skin cancer risk. This review summarizes current epidemiological evidence on the association between common PSMs and skin cancer. (2) A comprehensive literature search was conducted to identify meta-analyses, observational studies and clinical trials that report on skin cancer events in PSM users. The associated risks of keratinocyte carcinoma (squamous cell carcinoma and basal cell carcinoma) and melanoma are summarized, for each PSM. (3) There are extensive reports on antihypertensives and statins relative to other PSMs, with positive and null findings, respectively. Fewer studies have explored amiodarone, metformin, antimicrobials and vemurafenib. No studies report on the individual skin cancer risks in glyburide, naproxen, piroxicam, chlorpromazine, thioridazine and nalidixic acid users. (4) The research gaps in understanding the relationship between PSMs and skin cancer outlined in this review should be prioritized because the US population is aging. Thus the number of patients prescribed PSMs is likely to continue to rise.

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“…that found an increase in melanomas, specifically nodular and lentigo melanomas, in patients treated with hydrochlorothiazide. 6,40,41 Based on recent evidence, the British and Irish Hypertension Society recommended that thiazide-like drugs (e.g. chlorthalidone or indapamide) be preferred over thiazide diuretics (e.g.…”

Section: Skin Cancermentioning

confidence: 99%

Recent Warnings about Antihypertensive Drugs and Cancer Risk: Where Do They Come From?

Battistoni

Volpe

2020

Eur Cardiol

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The recent decrease in mortality related to cardiovascular diseases has largely been due to the more effective treatment of cardiovascular risk factors and secondary prevention therapies. More people than ever are now on long-term medications. Hypertension, which is one of the most common cardiovascular risk factors, requires life-long treatment. Recent evidence has focused attention on the risk of cancer that may be associated with the long-term use of antihypertensive therapy. This article summarises available evidence surrounding three recent events in this setting. Even though this is a crucial patient safety issue, there are no conclusive answers at this time and further studies are required.

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Do Thiazide Diuretics Increase the Risk of Skin Cancer? A Critical Review of the Scientific Evidence and Updated Meta-Analysis

Cited by 22 publications

References 40 publications

The Relationship Between Anti-Hypertensive Drugs and Cancer: Anxiety to be Resolved in Urgent

The Relationship Between Anti-Hypertensive Drugs and Cancer: Anxiety to be Resolved in Urgent

Photosensitizing Medications and Skin Cancer: A Comprehensive Review

Recent Warnings about Antihypertensive Drugs and Cancer Risk: Where Do They Come From?

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