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dc.contributor.authorSurapon Nochaiwongen_US
dc.contributor.authorMati Chuamanochanen_US
dc.contributor.authorChidchanok Ruengornen_US
dc.contributor.authorKajohnsak Noppakunen_US
dc.contributor.authorRatanaporn Awiphanen_US
dc.contributor.authorChabaphai Phosuyaen_US
dc.contributor.authorNapatra Tovanabutraen_US
dc.contributor.authorSiri Chiewchanviten_US
dc.contributor.authorManish M. Sooden_US
dc.contributor.authorBrian Huttonen_US
dc.contributor.authorKednapa Thavornen_US
dc.contributor.authorGreg A. Knollen_US
dc.description.abstractBackground: The use of thiazide diuretics is associated with skin cancer risk; however, whether this applies to all skin cancer types is unclear. Methods: In this meta-analysis, we searched multiple electronic databases and gray literature up to 10 April 2022, with no language restrictions, to identify relevant randomized controlled trials (RCTs) and non-randomized studies (cohort, casecontrol) that investigated the association between thiazide diuretics and skin cancer. The primary outcomes of interest were malignant melanoma and non-melanoma skin cancer (basal cell carcinoma [BCC], squamous cell carcinoma [SCC]). Secondary outcomes included other skin cancers (lip cancer, Merkel cell carcinoma, malignant adnexal skin tumors, oral cavity cancer, and precursors of skin cancer). We used a random-effects meta-analysis to estimate pooled adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Results: Thirty non-randomized studies (17 case-control, 13 cohort, no RCTs) were included. Thiazide diuretic users had a higher risk of malignant melanoma (17 studies; n = 10,129,196; pooled adjusted OR, 1.10; 95% CI, 1.04–1.15; p < 0.001; strength of evidence, very low; very small harmful effect), BCC (14 studies; n = 19,780,476; pooled adjusted OR, 1.05; 95% CI, 1.02–1.09; p = 0.003; strength of evidence, very low; very small harmful effect), and SCC (16 studies; n = 16,387,862; pooled adjusted OR, 1.35; 95% CI, 1.22–1.48; p < 0.001; strength of evidence, very low; very small harmful effect) than non-users. Thiazide diuretic use was also associated with a higher risk of lip cancer (5 studies; n = 161,491; pooled adjusted OR, 1.92; 95% CI, 1.52–2.42; p < 0.001; strength of evidence, very low; small harmful effect), whereas other secondary outcomes were inconclusive. Conclusions: Thiazide diuretics are associated with the risk of all skin cancer types, including malignant melanoma; thus, they should be used with caution in clinical practice.en_US
dc.subjectBiochemistry, Genetics and Molecular Biologyen_US
dc.titleUse of Thiazide Diuretics and Risk of All Types of Skin Cancers: An Updated Systematic Review and Meta-Analysisen_US
article.volume14en_US'Hôpital d'Ottawaen_US of Medicine, Chiang Mai Universityen_US of Ottawaen_USé d'Ottawa, Faculté de Médecineen_US Hospital Research Instituteen_US Mai Universityen_US
Appears in Collections:CMUL: Journal Articles

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