Observational studyCMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne2021
Association between antihypertensive medications and risk of skin cancer in people older than 65 years: a population-based study.
Observational study in CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed, 34 citations in OpenAlex.
- Photosensitizing Drugs and Risk of Skin Cancer in Women-A Prospective Population-Based Study.Photodermatology, photoimmunology & photomedicine · 2025Article
- Antihypertensive medications and cancer risk: Evidence from 0.27 million patients with newly diagnosed hypertension.Frontiers in pharmacology · 2025Article
- Article
- Prescription Trends of Thiazide Diuretics in a Canadian Primary Care Population From 2015 to 2021.CJC open · 2024Article
- Relationship Between Clozapine and Non-Hematological Malignant Tumors: A Pharmacovigilance Analysis Using the FDA Adverse Event Reporting System Database.Drugs - real world outcomes · 2024Article
- Antihypertensive Medications and Risk of Melanoma and Keratinocyte Carcinomas: A Systematic Review and Meta-Analysis.JID innovations : skin science from molecules to population health · 2024Article
- The phenomenon of phototoxicity and long-term risks of commonly prescribed and structurally diverse drugs.Journal of photochemistry and photobiology · 2024Article
- Renin-angiotensin system inhibitors improve the survival of cholangiocarcinoma: a propensity score-matched cohort study.BMC cancer · 2023Article
- The effect of hydrochlorothiazide on the recurrence of nonmelanoma skin cancer: a 7-year retrospective study comprising 300 patients.Turkish journal of medical sciences · 2023Article
- Use of Thiazide Diuretics and Risk of All Types of Skin Cancers: An Updated Systematic Review and Meta-Analysis.Cancers · 2022Review
- Flecainide and risk of skin neoplasms: Results of a large nested case-control study in Spain and Denmark.Frontiers in pharmacology · 2022Article
- Association between thiazide diuretics and skin cancer: still nebulous.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021Article
- Consider patient risk factors for melanoma when prescribing antihypertensives.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021Article
- The authors reply to: "Antihypertensives and skin cancer" and "Association between thiazide diuretics and skin cancer: still nebulous".CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2021Article
- Neurobiology of Cancer: Introduction of New Drugs in the Treatment and Prevention of Cancer.International journal of molecular sciences · 2021Review
- The Effect of Local Renin Angiotensin System in the Common Types of Cancer.Frontiers in endocrinology · 2021Review
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Authors and funding
7 authors at 5 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe risk of skin cancer associated with antihypertensive medication use is unclear, although thiazides have been implicated in regulatory safety warnings. We aimed to assess whether use of thiazides and other antihypertensives is associated with increased rates of keratinocyte carcinoma and melanoma.
methodsWe conducted a population-based inception cohort study using linked administrative health data from Ontario, 1998-2017. We matched adults aged ≥ 66 years with a first prescription for an antihypertensive medication (thiazides, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, β-blockers) by age and sex to 2 unexposed adults who were prescribed a non-antihypertensive medication within 30 days of the index date. We evaluated each antihypertensive class in a separate cohort study. Our primary exposure was the cumulative dose within each class, standardized according to the World Health Organization's Defined Daily Dose. Outcomes were time to first keratinocyte carcinoma, advanced keratinocyte carcinoma and melanoma.
resultsThe inception cohorts included a total of 302 634 adults prescribed an antihypertensive medication and 605 268 unexposed adults. Increasing thiazide exposure was associated with an increased rate of incident keratinocyte carcinoma (adjusted hazard ratios [HRs] per 1 Defined Annual Dose unit 1.08, 95% confidence interval [CI] 1.03-1.14), advanced keratinocyte carcinoma (adjusted HR 1.07, 95% CI 0.93-1.23) and melanoma (adjusted HR 1.34, 95% CI 1.01-1.78). We found no consistent evidence of association between other antihypertensive classes and keratinocyte carcinoma or melanoma.
interpretationHigher cumulative exposure to thiazides was associated with increased rates of incident skin cancer in people aged 66 years and older. Consideration of other antihypertensive treatments in patients at high risk of skin cancer may be warranted.
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