HCT treatment tied to lower cancer risk, except skin cancer, vs other diuretics

Treatment with hydrochlorothiazide (HCT) contributes to a lower all-cancer risk and a slightly higher skin cancer risk compared with alternative diuretics, reports a study involving a German population.

A total of 199,708 patients were included in the analysis, of which 76,855 received HCT, while 122,853 received non-HCT diuretics. After propensity score matching, 122,554 patients continued in the study (n=61,277 for both groups; mean age 73 years, 61 percent female; >96 percent had hypertension).

HCT treatment resulted in a reduced incidence of any cancer compared with non-HCT diuretics (incidence rate ratio per 100 patient-years, 0.84, 95 percent confidence interval [CI], 0.82‒0.87). HCT treatment also correlated with a small but significantly higher incidence of skin cancer (incidence rate ratio, 1.15, 95 percent CI, 1.06‒1.24), with significant differences over time.

“Although numerically higher, the difference accounts to only 0.05 more skin cancer diagnoses in 100 patient-years,” the investigators said.

This retrospective cohort study used data from the AOK PLUS, a large German statutory health insurance fund. The investigators matched patients with HCT treatment to those using non-HCT diuretics and examined the incidence of cancer of any kind and skin cancer, specifically. They then assessed and compared the time-to-incident cancer diagnosis between the two treatment groups.

“Risk–benefit evaluation should be executed in patients with increased skin cancer risk and treatment with HCT,” the investigators said. “Furthermore, advice for skin protection is warranted in all patients taking thiazide or thiazide-like diuretics.”