THIAZIDE DIURETICS AND SKIN CANCER – A REAL RISK?
DOI:
https://doi.org/10.58043/rphrc.60Abstract
Introduction: Thiazide diuretics are first-line drugs in the treatment of arterial hypertension. Due to its photosensitizing properties, it remains unclear whether its prolonged use increases the risk of skin cancer.
Aim: To evaluate the possible association between the use of thiazide diuretics and the diagnosis of skin cancer.
Methodology: Research in major online medical databases, with MeSH terms “thiazide diuretics” AND “skin cancer”, with no population restrictions except medication with thiazide diuretics. The comparator was the absence of thiazide/ administration of placebo/other antihypertensive and the outcome was of skin cancer.
Results: 13 articles were included – 3 retrospective cohorts, 1 prospective cohort, 6 case-control studies and 3 meta-analyses. 9 studies reported an association between the use of thiazides and the development of skin cancer, namely melanoma, squamous cell carcinoma and basal cell carcinoma. Several authors report a clear dose-response relationship between the use of hydrochlorothiazide and the incidence of basal and squamous cell carcinoma. The remaining studies do not support this relationship remaining a controversial issue.
Conclusion: These results should be analyzed carefully, since, although there is a statistically significant relationship between the risk of developing skin cancer and the administration of thiazide diuretics, this risk is low, so these drugs should not be discontinued when their antihypertensive benefit is evident and greater than the potential risk.
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