Hydrochlorothiazide use, sun exposure, and risk of keratinocyte cancer

Abstract Background Keratinocyte cancer (KC) rates are increasing in the U.S., particularly in older age groups. Use of hydrochlorothiazide (HCTZ), due to its photosensitizing properties, and high sun exposure are two known NMSC risk factors, but their synergistic effects are undetermined. The purpo...

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Main Authors: Jeffrey J. VanWormer (Author), Eseoghene B. Abokede (Author), Richard L. Berg (Author)
Format: Book
Published: BMC, 2022-07-01T00:00:00Z.
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042 |a dc 
100 1 0 |a Jeffrey J. VanWormer  |e author 
700 1 0 |a Eseoghene B. Abokede  |e author 
700 1 0 |a Richard L. Berg  |e author 
245 0 0 |a Hydrochlorothiazide use, sun exposure, and risk of keratinocyte cancer 
260 |b BMC,   |c 2022-07-01T00:00:00Z. 
500 |a 10.1186/s12889-022-13705-9 
500 |a 1471-2458 
520 |a Abstract Background Keratinocyte cancer (KC) rates are increasing in the U.S., particularly in older age groups. Use of hydrochlorothiazide (HCTZ), due to its photosensitizing properties, and high sun exposure are two known NMSC risk factors, but their synergistic effects are undetermined. The purpose of this study was to examine the development of NMSC between adults who did and did not use HCTZ, as well as those with high and low sun exposure. Methods A retrospective case-control sample was assembled from adult patients in north-central Wisconsin (USA). Duration of HCTZ use and occupational sun exposure were extracted from electronic health records, along with a linked survey of lifetime sun exposure. Results There were 333 cases and 666 controls in the analytical sample. A significant main effect was observed for HCTZ duration in the full sample. Under low sun exposure, the odds of NMSC was 14% greater for each additional year of HCTZ use (aOR = 1.14 [1.11, 1.18], p < 0.001). In a sensitivity analysis of participants age 70 years and over, there was a borderline significant (p = 0.086) HCTZ use by high sun exposure interaction, suggesting modestly increased HCTZ risk in older, high sun exposure adults. Conclusions Consistent with prior studies, longer duration of HCTZ use was a predictor of NMSC in north-central Wisconsin adults. NMSC may be accelerated in HCTZ users with outdoor lifestyles, but future studies should attempt to further disaggregate specific effects of sun exposure time, HCTZ duration, and age on NMSC development. 
546 |a EN 
690 |a Hydrochlorothiazide 
690 |a Sun 
690 |a Skin Cancer 
690 |a Prevention 
690 |a Adults 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n BMC Public Health, Vol 22, Iss 1, Pp 1-7 (2022) 
787 0 |n https://doi.org/10.1186/s12889-022-13705-9 
787 0 |n https://doaj.org/toc/1471-2458 
856 4 1 |u https://doaj.org/article/f3c8abeda3e74861b9b4e7de1a7aa685  |z Connect to this object online.