Risk of skin cancer from hydrochlorothiazide and other diuretics across races: A global cohort study

IF 4.6 3区环境科学与生态学 Q2 ENVIRONMENTAL SCIENCES

Environmental toxicology and pharmacology Pub Date : 2026-06-01 Epub Date: 2026-05-20 DOI:10.1016/j.etap.2026.105043

Chaw-Ning Lee , Shih-Chieh Shao , Chao-Chun Yang , Jia-Horung Hung , Edward Chia-Cheng Lai , Ching-Chi Chi

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引用次数: 0

Abstract

Background

Hydrochlorothiazide (HCTZ) has been linked to increased skin cancer risk. However, comparative evidence across racial groups remains limited. Using TriNetX, a global database, we evaluated the association between thiazide diuretic use and skin cancer risk across whites and other races within a single analytic platform, including both HCTZ and non-HCTZ thiazides.

Objective

To determine if the skin cancer risk associated with thiazide diuretics varies by racial group.

Methods

Using the TriNetX platform, we analyzed adults with newly treated hypertension, applying propensity score matching for baseline covariates, and calculated adjusted hazard ratios (aHRs) for skin cancers.

Results

Comparing to non-diuretic antihypertensive drug (NDAH) use, HCTZ increased the risk of keratinocyte carcinomas (KC) (aHR 1.44), squamous cell carcinoma (aHR 1.67), basal cell carcinoma (aHR 1.43), and malignant melanoma (aHR 1.54) only in the White population. No increased risk was found in the Asian, Hispanic, or Black populations. Chlorthalidone showed a similar pattern for KC, with increased event rates only in the White population.

Conclusion

HCTZ is associated with an increased risk of skin cancers only among whites, while similar associations were not observed in other races. These findings may be considered when prescribing thiazide diuretics in this population.

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氢氯噻嗪和其他利尿剂的皮肤癌风险跨种族：一项全球队列研究

背景：氢氯噻嗪（HCTZ）与皮肤癌风险增加有关。然而，跨种族群体的比较证据仍然有限。使用TriNetX全球数据库，我们在单一分析平台上评估了白人和其他种族的噻嗪类利尿剂使用与皮肤癌风险之间的关系，包括HCTZ和非HCTZ噻嗪类药物。目的：确定噻嗪类利尿剂的皮肤癌风险是否因种族而异。方法：使用TriNetX平台，我们分析了新治疗的高血压成人患者，对基线协变量应用倾向评分匹配，并计算皮肤癌的调整危险比（aHRs）。结果：与使用非利尿剂降压药（NDAH）相比，HCTZ仅在白人人群中增加了角质细胞癌（KC）（aHR 1.40）、鳞状细胞癌（aHR 1.75）、基底细胞癌（aHR 1.46）和恶性黑色素瘤（aHR 1.37）的风险。在亚洲人、西班牙人或黑人人群中没有发现风险增加。氯噻酮在KC中表现出类似的模式，仅在白人人群中事件发生率增加。结论：HCTZ仅在白人中与皮肤癌风险增加有关，而在其他种族中未观察到类似的关联。这些发现可以作为在这一人群中开噻嗪类利尿剂处方的参考。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Environmental toxicology and pharmacology 医学-毒理学

CiteScore

7.00

自引率

4.70%

发文量

185

审稿时长

34 days

期刊介绍： Environmental Toxicology and Pharmacology publishes the results of studies concerning toxic and pharmacological effects of (human and veterinary) drugs and of environmental contaminants in animals and man. Areas of special interest are: molecular mechanisms of toxicity, biotransformation and toxicokinetics (including toxicokinetic modelling), molecular, biochemical and physiological mechanisms explaining differences in sensitivity between species and individuals, the characterisation of pathophysiological models and mechanisms involved in the development of effects and the identification of biological markers that can be used to study exposure and effects in man and animals. In addition to full length papers, short communications, full-length reviews and mini-reviews, Environmental Toxicology and Pharmacology will publish in depth assessments of special problem areas. The latter publications may exceed the length of a full length paper three to fourfold. A basic requirement is that the assessments are made under the auspices of international groups of leading experts in the fields concerned. The information examined may either consist of data that were already published, or of new data that were obtained within the framework of collaborative research programmes. Provision is also made for the acceptance of minireviews on (classes of) compounds, toxicities or mechanisms, debating recent advances in rapidly developing fields that fall within the scope of the journal.