Hydrochlorothiazide use is strongly associated with risk of lip cancer

Pottegård, Anton; Hallas, Jesper; Olesen, Morten; Svendsen, Mathias Tiedemann; Habel, Laurel A.; Friedman, Gary D.; Friis, Søren

doi:10.1111/joim.12629

Cited by 138 publications

(142 citation statements)

References 34 publications

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“…Results of previous studies of ADs and the risk of skin cancer have been inconsistent . While some have shown increased risk with the use of potassium‐sparing and combination diuretics, but not loop or thiazide diuretics, several studies, including one at KPNC, have shown a significant association between thiazide diuretic use and increased SCC risk . ACE inhibitors and ARBs have been associated with a reduced risk of keratinocyte cancers in some studies and an increased risk in others .…”

Section: Discussionmentioning

confidence: 99%

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Photosensitizing antihypertensive drug use and risk of cutaneous squamous cell carcinoma

Habel

Achacoso

et al. 2018

Br J Dermatol

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Section: Discussionmentioning

confidence: 99%

“…Epidemiological data on the association between photosensitizing drug use and cSCC risk remain limited. Photosensitizing ADs have been associated with lip cancers, the majority of which are mucosal squamous cell carcinomas (SCCs) . However, whether photosensitizing AD use affects cSCC risk is unclear.…”

mentioning

confidence: 99%

Photosensitizing antihypertensive drug use and risk of cutaneous squamous cell carcinoma

Habel

Achacoso

et al. 2018

Br J Dermatol

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“…Alcohol use may also act synergistically with tobacco abuse in lip cancers, although an exact risk exposure value is not known . More recently, HCTZ use has been associated with lip cancers with an odds ratio of 2.1 (95% confidence interval (CI): 1.7–2.6), increasing to 3.9 (95% CI, 3.0–4.9) for high use (≥25 000 mg) . In our series, 20 cutaneous perioral patients (17.2%) and 10 vermilion lip patients (22.2%) were taking HCTZ at the time of MMS.…”

Section: Discussionmentioning

confidence: 66%

Characteristics of non‐melanoma skin cancers of the cutaneous perioral and vermilion lip treated by Mohs micrographic surgery

Queen

Knackstedt

Polacco

et al. 2018

Acad Dermatol Venereol

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Background The lip and surrounding perioral region are susceptible to non‐melanoma skin cancer, but the distribution of basal cell and squamous cell carcinoma on the cutaneous and vermilion lips has not been fully elucidated. Objective To investigate the distribution of cutaneous and vermilion lip non‐melanoma skin cancer and to better describe risk factors, anatomic location, treatment characteristics and oncologic outcomes. Methods A retrospective comparative case series of patients undergoing Mohs micrographic surgery (MMS) at a single academic centre for lip and perioral basal cell and squamous cell carcinoma was performed over a 5‐year period. Demographics, medical comorbidities, surgical characteristics and recurrence status were extracted. Results Forty‐five vermilion and 116 cutaneous lip cancers were identified. Basal cell carcinoma (BCC) was more common in the cutaneous perioral region, while squamous cell carcinoma (SCC) was more common on the vermilion lip (P < 0.001). BCCs were more common on the upper vermilion lip and SCCs were more common on the lower vermilion lip (P < 0.001). Within the cutaneous perioral region, both BCCs and SCCs were more common on the upper perioral surface (P = 0.002). Male gender was associated with lower lip SCC (P = 0.015). Smoking, immunosuppression, anticoagulant use and hydrochlorothiazide use were not associated with cancer type or location. Recurrences were rare, but more common in vermilion lip cancers (6.6%) compared to perioral cutaneous cancers (0.8%). Outcomes for all groups were similar; BCCs of the vermilion lip had significantly greater mean MMS stages (P < 0.001) as did SCCs (P = 0.05). Conclusion Basal cell carcinoma is more commonly encountered on the cutaneous lip, whereas SCC is more common on the vermilion lip. Within the vermilion lip, BCC favours the upper lip, while SCC favours the lower lip. Within the cutaneous perioral region, both BCC and SCC favour the upper cutaneous tissue. Early stage lip cancers are curable by Mohs micrographic surgery with rare recurrences.

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“…The first matched 633 patients with squamous cell carcinoma (SCC) of the lip with 63 067 population controls 2. The second was a study of 71 533 patients with basal cell carcinoma (BCC) and 8629 case patients with SCC who were matched with 1 430 883 and 172 462 population controls, respectively 3. People exposed to the highest cumulative dose of hydrochlorothiazide (≥200 000 mg) were at increased risk of BCC (adjusted OR 1.54, 95% CI 1.38 to 1.71) and SCC (OR 7.38, 95% CI 6.32 to 8.60).…”

Section: Overviewmentioning

confidence: 99%

MHRA drug safety update: hydrochlorothiazide and non-melanoma skin cancer

2019

DTB

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Hydrochlorothiazide use is strongly associated with risk of lip cancer

Abstract: Hydrochlorothiazide use is strongly associated with an increased risk of lip cancer.

Cited by 138 publications

References 34 publications

Photosensitizing antihypertensive drug use and risk of cutaneous squamous cell carcinoma

Photosensitizing antihypertensive drug use and risk of cutaneous squamous cell carcinoma

Characteristics of non‐melanoma skin cancers of the cutaneous perioral and vermilion lip treated by Mohs micrographic surgery

MHRA drug safety update: hydrochlorothiazide and non-melanoma skin cancer

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