Association between hydrochlorothiazide and the risk of in situ and invasive squamous cell skin carcinoma and basal cell carcinoma: A population-based case-control study.
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AuthorsAdalsteinsson, Jonas A
Silverberg, Jonathan I
Olafsdottir, Gudridur H
Kristjansson, Arni Kjalar
Jonasson, Jon Gunnlaugur
MetadataShow full item record
CitationAdalsteinsson JA, Muzumdar S, Waldman R, Hu C, Wu R, Ratner D, Ungar J, Silverberg JI, Olafsdottir GH, Kristjansson AK, Tryggvadottir L, Jonasson JG. Association between hydrochlorothiazide and the risk of in situ and invasive squamous cell skin carcinoma and basal cell carcinoma: A population-based case-control study. J Am Acad Dermatol. 2021 Mar;84(3):669-675. doi: 10.1016/j.jaad.2020.08.025.
AbstractBackground: Population-based studies analyzing hydrochlorothiazide's (HCTZ's) effect on keratinocyte carcinoma, and particularly invasive squamous cell carcinoma (SCC), are lacking. Objectives: To characterize the association between HCTZ use and invasive SCC, SCC in situ (SCCis), and basal cell carcinoma (BCC). Methods: This population-based case-control study included all 6880 patients diagnosed with first-time BCC, SCCis, and invasive SCC between 2003 and 2017 in Iceland and 69,620 population controls. Conditional logistic regression analyses were used to calculate multivariate odds ratios (ORs) for keratinocyte carcinoma associated with HCTZ use. Results: A cumulative HCTZ dose above 37,500 mg was associated with increased risk of invasive SCC (OR, 1.69; 95% confidence interval [CI], 1.04-2.74). Users of HCTZ also had an increased risk of SCCis (OR, 1.24; 95% CI, 1.01-1.52) and BCC (OR, 1.14; 95% CI, 1.02-1.29). Limitations: Limitations include this study's retrospective nature with the resulting inability to adjust for ultraviolet exposure, Fitzpatrick skin type, and comorbidities. Conclusions: High cumulative exposure to HCTZ is associated with the development of keratinocyte carcinoma and, most importantly, invasive SCC. Sun protective behaviors alone may not eliminate the carcinogenic potential of HCTZ. Keywords: basal cell carcinoma; epidemiology; hydrochlorothiazide; keratinocyte carcinoma; squamous cell carcinoma.
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RightsCopyright © 2020 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
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Carcinoma ani á Íslandi 1987-2003 : lýðgrunduð rannsóknHalla Viðarsdóttir; Páll Helgi Möller; Jakob Jóhannsson; Jón Gunnlaugur Jónasson (Læknafélag Íslands, Læknafélag Reykjavíkur, 2006-05-01)OBJECTIVE: Anal cancer is a rare disease. The aim of this study was to describe anal cancer in Iceland in 1987-2003 with respect to incidence, histologic type, treatment, recurrence rate and survival. MATERIAL AND METHODS: This is a retrospective study in which all malignant anal tumours diagnosed in Iceland in the period 1987-2003 were reviewed with respect to patient outcome. Information was obtained from hospitals registers. All histological material was reviewed by a consultant histopathologist (JGJ). This is a nationwide, population-based study of malignant tumours of the anal region. RESULTS: From 1987-2003 thirty-eight patients were diagnosed with anal cancer, 28 females and 10 males. The average age at diagnosis was 63.4 years. Age standardized incidence rates for anal cancer in Iceland were 0.3 (+/-0.2) of 100.000 males and 0.9 (+/-0.4) of 100.000 females. Most patients had squamous cell carcinoma (n=30). The remaining histologic types were malignant melanoma (n=3), adenosquamous carcinoma (n=1), adenocarcinoma (n=1), GIST (n=1) and undifferentiated carcinoma (n=2). The most common symptoms were rectal bleeding (n=27), mass lesion (n=28), pain (n=19) and pruritus (n=4). Most patients had more than one symptom. The duration of symptoms before diagnosis ranged from 2 weeks to 96 months (mean value 3.5 months). Treatment modalities used were chemotherapy (n=12), radiotherapy (n=25) and local excision (n=18) and/or APR (n=5). One patient received no treatment. Many patients were treated with more than one treatment modality (n=18). Twelve patients had recurrent cancer. The mean value of the time from diagnosis of the primary to the recurrent cancer was 15.6 months (range, 5.9-117). Sixteen patients remain with disease and ten have died of anal cancer. The five year survival rate for patients diagnosed in the years 1987 to 1998 is 75% but cancer-specific survival is 82%. CONCLUSION: Age-standardized incidence for anal cancer in Iceland is similar to other regions. Average age at diagnosis, male-female ratio and prognosis is similar to reports in other studies. The proportion of adenocarcinoma of the anus is lower in Iceland than elsewhere.
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