Abstract
BACKGROUND: Hydrochlorothiazide (HCTZ) has carcinogenic effects owing to its photosensitizing properties. Recent studies have reported inconsistent results regarding the association between HCTZ and skin cancer. OBJECTIVE: This study aimed to clarify the effects of HCTZ on the risk of developing nonmelanoma skin cancer (NMSC) in Korean patients with hypertension. METHODS: This multicenter, retrospective cohort study was conducted using clinical data from 11 hospitals in Korea, and converted to the Observational Medical Outcomes Partnership-Common Data Model. Large-scale 1:1 propensity score-matching was conducted to balance the target and comparator cohorts. Cox regression analysis was used to examine the hazard ratio (HR) for NMSC in HCTZ users compared to HCTZ never-users. RESULTS: 8,821 patients and same number of controls were pooled from 11 databases. HCTZ use was not associated with a decreased risk of NMSC (HR, 1.01; 95% confidence interval [CI], 0.70-1.47). In the dose-response analysis, no significant correlation was found between NMSC risk and HCTZ dose for <1 year (HR, 1.17; 95% CI, 0.64-2.17) and ≥1 year (HR, 1.02; 95% CI, 0.64-1.61). No significant increase in the risk of NMSC was observed in the subgroup analyses for either age or sex. CONCLUSION: HCTZ was not associated with the development of NMSC in a Korean hypertensive population, regardless of the duration of drug exposure.