Hydrochlorothiazide increases risk of nonmelanoma skin cancer in an elderly Japanese cohort with hypertension: The Shizuoka study

Hashizume, Hideo; Nakatani, Eiji; Sasaki, Hatoko

doi:10.1016/j.jdin.2023.04.007

Cited by 9 publications

(6 citation statements)

References 55 publications

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“…No association was found between thiazides and basal cell carcinoma [39]. The association between squamous cell carcinoma and HCT was also confirmed in another population-based cohort study from Japan, including >400,000 hypertensive patients [40]. Another study investigated the association between thiazides and malignant melanoma, showing an increased risk for specific histological types of melanoma, namely nodular and lentigo subtypes [41].…”

Section: Antihypertensive Drugs and Carcinogenesismentioning

confidence: 83%

Onco-Hypertension: A Continuously Developing Field between Cancer and Hypertension

Totolici,

Vrabie,

Badila

et al. 2024

IJMS

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The prognosis of cancer patients has greatly improved in the last years, owing to the development of novel chemotherapeutic agents. However, this progress comes with an increasing occurrence of cardiovascular adverse reactions. A serious side effect is arterial hypertension (HT), which is the most frequent comorbidity encountered in cancer patients, influencing the outcomes in cancer survivors. Even though secondary HT related to specific chemotherapeutic agents, such as vascular endothelial growth factor inhibitors, is usually mild and reversible, in rare instances it can be severe, leading to discontinuation of chemotherapy. In addition, HT per se has been studied as a potential risk factor for cancer development. The relationship is even more complex than previously thought, as concerning evidence recently highlighted the potential oncogenic effects of antihypertensive drugs, particularly thiazide diuretics, which may increase the risk of skin cancer. As a result, in light of the similar risk factors and overlapping pathophysiological mechanisms between HT and cancer, a promising concept of onco-hypertension has emerged, aiming to improve the understanding of the complicated interplay between these two pathologies and maintain a balance between the efficacy and risks of both antihypertensive drugs and chemotherapy agents.

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Section: Antihypertensive Drugs and Carcinogenesismentioning

confidence: 83%

Onco-Hypertension: A Continuously Developing Field between Cancer and Hypertension

Totolici,

Vrabie,

Badila

et al. 2024

IJMS

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“…This discrepancy could be attributed to the influence of hypertension medication on the risk of developing skin cancer. A study from Japan indicated that hydrochlorothiazide (HCT), a commonly used antihypertensive medication, increased the risk of non-melanoma skin cancer in elderly individuals with dark skin, highlighting the increased risk of SCC among HCT users in aging societies worldwide [ 47 ]. In Taiwan, common antihypertensive medications include angiotensin-converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta-blockers (β-blocker), calcium channel blockers (CCB), and diuretics.…”

Section: Discussionmentioning

confidence: 99%

“…In Taiwan, common antihypertensive medications include angiotensin-converting enzyme inhibitors (ACEI), angiotensin II receptor blockers (ARB), beta-blockers (β-blocker), calcium channel blockers (CCB), and diuretics. Apart from the association of β-blockers with effective tumor immune response markers and their protective effects on human melanoma patients [ 46 , 47 , 48 , 49 ], other antihypertensive medications increase the risk of skin cancer [ 50 , 51 , 52 , 53 ]. Our results indicate an elevated risk of skin cancer with hypertension, but further research is needed to evaluate the associated risk of skin cancer after the use of antihypertensive medications in HPV patients.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies have suggested that systemic conditions like hypertension may impact skin cancer development due to biological mechanisms such as inflammation or immunomodulation, which are influenced by these chronic diseases. For instance, hypertension has been associated with an increased risk of skin cancer, potentially linked to the photosensitizing effects of certain antihypertensive medications [ 46 , 47 , 48 , 49 ]. While direct skin-related conditions like actinic keratosis or immune diseases were not explicitly included as covariates, the selected comorbidities were chosen based on their documented implications in altering biological pathways that could affect skin health.…”

Section: Discussionmentioning

confidence: 99%

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Synergistic Effect of Human Papillomavirus and Environmental Factors on Skin Squamous Cell Carcinoma, Basal Cell Carcinoma, and Melanoma: Insights from a Taiwanese Cohort

Chen,

Luo,

Tsai

et al. 2024

Cancers

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Human papillomavirus (HPV) has been implicated in various cancers, including those affecting the skin. The study assessed the long-term risk of skin cancer associated with HPV infection in Taiwan region, using data from the National Health Insurance Research Database between 2007 and 2015. Our analysis revealed a significant increase in skin cancer risk among those with HPV, particularly for squamous cell carcinoma (SCC), the subtype with the highest observed adjusted hazard ratio (aHR) = 5.97, 95% CI: 4.96–7.19). The overall aHR for HPV-related skin cancer was 5.22 (95% CI: 4.70–5.80), indicating a notably higher risk in the HPV-positive group. The risk of skin cancer was further stratified by type, with basal cell carcinoma (aHR = 4.88, 95% CI: 4.14–5.74), and melanoma (aHR = 4.36, 95% CI: 2.76–6.89) also showing significant associations with HPV. The study also highlighted regional variations, with increased risks in southern Taiwan and the Kaohsiung-Pingtung area. Key findings emphasize the importance of sun protection, particularly in regions of high UV exposure and among individuals in high-risk occupations. This research contributes to a better understanding of the complex interactions between HPV and skin cancer risk, reinforcing the importance of preventive strategies in public health.

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“…[43][44][45] The main limitations of the Danish population study and a cohort of Japanese with hypertension, which suggest such a risk, are the lack of information regarding other relevant factors, such as sun exposure, the use of sunscreen, and the lack of adjustment for other variables, including the use of other photosensitizing medications and CCBs. 46,47 There are still conflicting data in the literature about exposure to photosensitizing medications and AKs/SCCs. A Brazilian study did not demonstrate an association between exposure to hydrochlorothiazide and the occurrence of nonmelanoma skin cancer (NMSC).…”

Section: Discussionmentioning

confidence: 99%

Association between calcium channel blockers and the severity of actinic keratosis on face and scalp: a cross‐sectional study

Gioppo,

de Castro Martins,

Santos

et al. 2023

Int J Dermatology

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BackgroundActinic keratosis (AK) is a skin condition associated with age, sun exposure, and immunosuppression. Certain drugs, such as photosensitizing medications and calcium channel blockers (CCBs), have been linked to AK. This study explores the impact of individual, behavioral, and exposure factors on the severity of AKs on the face and scalp.MethodsA multicenter cross‐sectional study was conducted on immunocompetent individuals with at least one AK on their face or scalp and assessed demographic factors, sun exposure and protection, history of skin cancer, and medication use within the last 6 months. The primary outcome was the Actinic Keratosis Area and Severity Index (AKASI) score, and a hierarchical generalized linear model was used to evaluate the variation in AKASI scores, adjusting for gender, age, and skin phototype.ResultsTwo hundred seventy subjects between 39 and 92 years were evaluated. The majority had phototype I or II (77%), male gender (51%), personal history of skin cancer (55%), and low adherence to sunscreen use (29%). The use of photosensitizing medications was reported by 61%. Through multivariate analysis, older age (βSE = 0.14; P < 0.01), lighter skin phototype (βSE = 0.15; P = 0.01), history of skin cancer (βSE = 0.12; P < 0.01), sunburning (βSE = 0.12; P < 0.01), and use of CCBs (βSE = 0.11; P = 0.02) were identified as independent risk factors for AK severity. Photosensitizing drugs were not identified as risk factors.ConclusionOlder age, lower skin phototype classifications, and a personal history of skin cancer were confirmed as severity risk factors for AK, while the use of CCBs was associated with more severe AK.

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Hydrochlorothiazide increases risk of nonmelanoma skin cancer in an elderly Japanese cohort with hypertension: The Shizuoka study

Cited by 9 publications

References 55 publications

Onco-Hypertension: A Continuously Developing Field between Cancer and Hypertension

Onco-Hypertension: A Continuously Developing Field between Cancer and Hypertension

Synergistic Effect of Human Papillomavirus and Environmental Factors on Skin Squamous Cell Carcinoma, Basal Cell Carcinoma, and Melanoma: Insights from a Taiwanese Cohort

Association between calcium channel blockers and the severity of actinic keratosis on face and scalp: a cross‐sectional study

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