고혈압 환자의 히드로클로로티아지드 사용과 비흑색종 피부암 발생 위험: 코호트 내 환자-대조군 연구 = Hydrochlorothiazide Use and the Risk of Non-Melanoma Skin Cancer in Hypertensives: A Nested Case-Control Study

다국어 초록 (Multilingual Abstract)

Safety concerns regarding skin cancer associated with hydrochlorothiazide (HCTZ), a commonly prescribed antihypertensive, have been raised.
However, previous studies mainly focused on Caucasian populations. Therefore, we assessed the risk of non-melanoma skin cancer (NMSC) in HCTZ users with hypertension compared to non-users. Methods: This nested case-control study used National Health Insurance claims data from 2002 to 2017. The cohort comprised patients aged ≥ 30 years with hypertension (Korean Standard Classification of Diseases and Causes of Death, 7th revision, KCD-7: I10-I15) and no prior to NMSC diagnosis (KCD-7: C44) or HCTZ prescriptions within one year before hypertension diagnosis (entry date). NMSC cases diagnosed between 2008 and 2017 were identified, and 1:4 matched controls without NMSC were selected using riskset sampling. HCTZ use was assessed from the entry date to two years prior to NMSC diagnosis. Conditional logistic regression was used to estimate the odds ratio (OR) for the association between HCTZ use and NMSC, adjusted for potential confounders. Results: The use of HCTZ was not significantly associated with NMSC risk (Odds Ratio [OR]: 1.02, 95% CI: 0.98–1.07), indicating no meaningful difference in risk. Analysis of cumulative dose and long-term use of HCTZ did not reveal significant differences. Additionally, systemic retinoid use (OR: 1.97, 95% CI: 1.27–3.05) and radiation-related skin diseases (OR: 6.85, 95% CI: 5.46–8.59) demonstrated a significant association with NMSC risk. Conclusion: The use of HCTZ did not demonstrate a significant association with NMSC in this study, suggesting that its use may not be a concern regarding NMSC risk in Asian populations