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Hydrochlorothiazide use is strongly associated with risk of lip cancer
Author(s) -
Pottegård A.,
Hallas J.,
Olesen M.,
Svendsen M. T.,
Habel L. A.,
Friedman G. D.,
Friis S.
Publication year - 2017
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1111/joim.12629
Subject(s) - hydrochlorothiazide , medicine , odds ratio , diuretic , confidence interval , cancer , confounding , medical prescription , population , oncology , pharmacology , blood pressure , environmental health
Background The diuretic hydrochlorothiazide is amongst the most frequently prescribed drugs in the United States and Western Europe, but there is suggestive evidence that hydrochlorothiazide use increases the risk of lip cancer. Objectives To study the association between use of hydrochlorothiazide and squamous cell carcinoma of the lip. Methods We conducted a case–control study using Danish nationwide registry data. From the Cancer Registry (2004–2012), we identified 633 case patients with squamous cell carcinoma ( SCC ) of the lip and matched them to 63 067 population controls using a risk‐set sampling strategy. Hydrochlorothiazide use (1995–2012) was obtained from the Prescription Registry and defined according to cumulative use. Applying conditional logistic regression, we calculated odds ratios ( OR s) for SCC lip cancer associated with hydrochlorothiazide use, adjusting for predefined potential confounders obtained from demographic, prescription and patient registries. Results Ever‐use of hydrochlorothiazide was associated with an adjusted OR for SCC lip cancer 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). There was a clear dose–response effect ( P < 0.001), with the highest cumulative dose category of hydrochlorothiazide (≥100 000 mg) presenting an OR of 7.7 (95% CI : 5.7–10.5). No association with lip cancer was seen with use of other diuretics or nondiuretic antihypertensives. Assuming causality, we estimated that 11% of the SCC lip cancer cases could be attributed to hydrochlorothiazide use. Conclusions Hydrochlorothiazide use is strongly associated with an increased risk of lip cancer.