Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark.
Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark.
J Intern Med. 2017 Oct;282(4):322-331. doi: 10.1111/joim.12629. Epub 2017 Jun 6.
The diuretic hydrochlorothiazide is amongst the most frequently prescribed drugs in the United States and Western Europe, but there is suggestive evidence that hydrochlorothiazide use increases the risk of lip cancer.
To study the association between use of hydrochlorothiazide and squamous cell carcinoma of the lip.
We conducted a case-control study using Danish nationwide registry data. From the Cancer Registry (2004-2012), we identified 633 case patients with squamous cell carcinoma (SCC) of the lip and matched them to 63 067 population controls using a risk-set sampling strategy. Hydrochlorothiazide use (1995-2012) was obtained from the Prescription Registry and defined according to cumulative use. Applying conditional logistic regression, we calculated odds ratios (ORs) for SCC lip cancer associated with hydrochlorothiazide use, adjusting for predefined potential confounders obtained from demographic, prescription and patient registries.
Ever-use of hydrochlorothiazide was associated with an adjusted OR for SCC lip cancer of 2.1 (95% confidence interval (CI): 1.7-2.6), increasing to 3.9 (95%CI: 3.0-4.9) for high use (≥25 000 mg). There was a clear dose-response effect (P < 0.001), with the highest cumulative dose category of hydrochlorothiazide (≥100 000 mg) presenting an OR of 7.7 (95%CI: 5.7-10.5). No association with lip cancer was seen with use of other diuretics or nondiuretic antihypertensives. Assuming causality, we estimated that 11% of the SCC lip cancer cases could be attributed to hydrochlorothiazide use.
Hydrochlorothiazide use is strongly associated with an increased risk of lip cancer.
氢氯噻嗪是美国和西欧最常开的药物之一，但有证据表明氢氯噻嗪的使用会增加唇癌的风险。
研究氢氯噻嗪的使用与唇鳞状细胞癌的关系。
我们使用丹麦全国性登记数据进行了病例对照研究。从癌症登记处（2004-2012 年），我们确定了 633 例唇鳞状细胞癌（SCC）患者病例，并使用风险集抽样策略将他们与 63067 名人群对照匹配。从处方登记处获得氢氯噻嗪的使用情况（1995-2012 年），并根据累积使用量进行定义。应用条件逻辑回归，我们计算了与氢氯噻嗪使用相关的唇癌 SCC 的比值比（OR），调整了从人口统计学、处方和患者登记处获得的预定义潜在混杂因素。
氢氯噻嗪的使用与唇 SCC 的调整 OR 为 2.1（95%置信区间（CI）：1.7-2.6），高剂量（≥25000mg）的 OR 增加至 3.9（95%CI：3.0-4.9）。存在明显的剂量反应效应（P<0.001），氢氯噻嗪的累积剂量最高类别（≥100000mg）的 OR 为 7.7（95%CI：5.7-10.5）。使用其他利尿剂或非利尿剂降压药与唇癌无关。假设因果关系，我们估计 11%的唇 SCC 病例可归因于氢氯噻嗪的使用。
氢氯噻嗪的使用与唇癌的风险增加密切相关。
