Evidence map›Paper›PMID 35626169›Full record

ReviewCancers2022

Use of Thiazide Diuretics and Risk of All Types of Skin Cancers: An Updated Systematic Review and Meta-Analysis.

Surapon Nochaiwong, Mati Chuamanochan, Chidchanok Ruengorn, Kajohnsak Noppakun, Ratanaporn Awiphan, Chabaphai Phosuya, Napatra Tovanabutra, Siri Chiewchanvit, Manish M Sood, Brian Hutton and 2 more

Open access · goldAbstract readReview
In one paragraph

Review in Cancers, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
3.0field-weighted citation impact, top 8% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 19 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Diuretics in patients with chronic kidney disease.Nature reviews. Nephrology · 2025
    Review
  5. Article
  6. Article
  7. Article
  8. Article
  9. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 2 institutions in 2 countries.

Surapon NochaiwongDepartment of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand.ORCID 0000-0003-1100-7171
Mati ChuamanochanPharmacoepidemiology and Statistics Research Center (PESRC), Chiang Mai University, Chiang Mai 50200, Thailand.
Chidchanok RuengornDepartment of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand.
Kajohnsak NoppakunPharmacoepidemiology and Statistics Research Center (PESRC), Chiang Mai University, Chiang Mai 50200, Thailand.
Ratanaporn AwiphanDepartment of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand.
Chabaphai PhosuyaDepartment of Pharmaceutical Care, Faculty of Pharmacy, Chiang Mai University, Chiang Mai 50200, Thailand.
Napatra TovanabutraDepartment of Internal Medicine, Division of Dermatology, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Siri ChiewchanvitPharmacoepidemiology and Statistics Research Center (PESRC), Chiang Mai University, Chiang Mai 50200, Thailand.
Manish M SoodDepartment of Medicine, Division of Nephrology, University of Ottawa, Ottawa, ON K1H 8L6, Canada.
Brian HuttonOttawa Hospital Research Institute, Ottawa Hospital, Ottawa, ON K1H 8L6, Canada.
Kednapa ThavornPharmacoepidemiology and Statistics Research Center (PESRC), Chiang Mai University, Chiang Mai 50200, Thailand.ORCID 0000-0003-4738-8447
Greg A KnollDepartment of Medicine, Division of Nephrology, University of Ottawa, Ottawa, ON K1H 8L6, Canada.
Chiang Mai University · THUniversity of Ottawa · CA

Funding

Faculty of Medicine, Chiang Mai University, Thailand MED2564/08165Pharmacoepidemiology and Statistics Research Center (PESRC) through the Chiang Mai University. ORA2564/635
6 · The paper itself

Abstract

Background: The use of thiazide diuretics is associated with skin cancer risk; however, whether this applies to all skin cancer types is unclear. Methods: In this meta-analysis, we searched multiple electronic databases and gray literature up to 10 April 2022, with no language restrictions, to identify relevant randomized controlled trials (RCTs) and non-randomized studies (cohort, case-control) that investigated the association between thiazide diuretics and skin cancer. The primary outcomes of interest were malignant melanoma and non-melanoma skin cancer (basal cell carcinoma [BCC], squamous cell carcinoma [SCC]). Secondary outcomes included other skin cancers (lip cancer, Merkel cell carcinoma, malignant adnexal skin tumors, oral cavity cancer, and precursors of skin cancer). We used a random-effects meta-analysis to estimate pooled adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: Thirty non-randomized studies (17 case-control, 13 cohort, no RCTs) were included. Thiazide diuretic users had a higher risk of malignant melanoma (17 studies; n = 10,129,196; pooled adjusted OR, 1.10; 95% CI, 1.04−1.15; p < 0.001; strength of evidence, very low; very small harmful effect), BCC (14 studies; n = 19,780,476; pooled adjusted OR, 1.05; 95% CI, 1.02−1.09; p = 0.003; strength of evidence, very low; very small harmful effect), and SCC (16 studies; n = 16,387,862; pooled adjusted OR, 1.35; 95% CI, 1.22−1.48; p < 0.001; strength of evidence, very low; very small harmful effect) than non-users. Thiazide diuretic use was also associated with a higher risk of lip cancer (5 studies; n = 161,491; pooled adjusted OR, 1.92; 95% CI, 1.52−2.42; p < 0.001; strength of evidence, very low; small harmful effect), whereas other secondary outcomes were inconclusive. Conclusions: Thiazide diuretics are associated with the risk of all skin cancer types, including malignant melanoma; thus, they should be used with caution in clinical practice.

Indexed as

basal cell carcinomakeratinocyte carcinomamelanomameta-analysisskin cancerssquamous cell carcinomathiazide diuretics

Identifiers

PMID35626169
PMCPMC9140049
OpenAlexW4281386836

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.