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

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.