J Clin Med. 2020;9(9):jcm9092910.

Association between Use of Hydrochlorothiazide and Nonmelanoma Skin Cancer: Common Data Model Cohort Study in Asian Population.

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제1저자 이승민 · 교신저자 윤형진, 이해영

PMID 32916988 PMC7563303 DOI 10.3390/jcm9092910 IF 3.3 순환기내과

소속 (13)

Department of Biomedical Engineering, Seoul National University College of Medicine, Seoul 03080, Korea.
Transdisciplinary Department of Medicine & Advanced Technology, Seoul National University College of Medicine, Seoul 03080, Korea.
Washington University School of Medicine in St. Louis, St. Louis, MO 63110-1010, USA.
Department of Preventive Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.
Cancer Research Institute, Seoul National University, Seoul 03080, Korea.
Convergence Graduate Program in Innovative Medical Science, Seoul National University College of Medicine, Seoul 03080, Korea.
Interdisciplinary Program in Cancer Biology Major, Seoul National University College of Medicine, Seoul 03080, Korea.
Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
Department of Biomedical Informatics Health Innovation Big Data Center, Asan Medical Center, Seoul 05505, Korea.
Healthcare ICT Research Center, Office of eHealth Research and Businesses, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam 13620, Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea.
Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Korea.

Abstract

UNLABELLED Although hydrochlorothiazide (HCTZ) has been suggested to increase skin cancer risk in white Westerners, there is scant evidence for the same in Asians. We analyzed the association between the use of hydrochlorothiazide and non-melanoma in the Asian population using the common data model.

METHODS A retrospective multicenter observational study was conducted using a distributed research network to analyze the effect of HCTZ on skin cancer from 2004 to 2018. We performed Cox regression to evaluate the effects by comparing the use of HCTZ with other antihypertensive drugs. All analyses were re-evaluated using matched data using the propensity score matching (PSM). Then, the overall effects were evaluated by combining results with the meta-analysis.

RESULTS Positive associations were observed in the use of HCTZ with high cumulative dose for non-melanoma skin cancer (NMSC) in univariate analysis prior to the use of PSM. Some negative associations were observed in the use of low and medium cumulative doses.

CONCLUSION Although many findings in our study were inconclusive, there was a non-significant association of a dose-response pattern with estimates increasing in cumulative dose of HCTZ. In particular, a trend with a non-significant positive association was observed with the high cumulative dose of HCTZ.

Keywords

Cox regressiondose-response relationshiphydrochlorothiazidemelanomanon-melanomaskin cancer

Figures

**Figure 1** The flowchart of study participants in the CDM network.

**Figure 2** The overall effect of HCTZ use on NMSC in the CDM network for three cases (“Ever use”, “HCTZ-only use”, and “Combination use”). Each analysis was tested for heterogeneity (“Test*” indicates Cochran’s Q and I² value tests). In the significant association, the chi-square test for heterogeneity was non-significant and its I² value was zero. These suggest that there was little between-study variability in the found association.

**Figure 3** The overall dose-response effect of HCTZ use on NMSC in the CDM network for “Ever use”. Each analysis was tested for heterogeneity (“Test*” indicates Cochran’s Q and I² value tests). In the significant associations, the chi-square tests for heterogeneity in most cases were insignificant and its I² values were almost zero. These suggest that there was little between-study variability in the found associations.

그림 출처: PubMed Central 공개 논문 (PMC7563303)

Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

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