European studies reported an increased risk of non-melanoma skin cancer associated with hydrochlorothiazide (HCTZ)-containing products. We examined the risks of basal cell (BCC) and squamous cell carcinoma (SCC) associated with HCTZ compared to angiotensin-converting enzyme inhibitors (ACEIs) in a US population.
We conducted a retrospective cohort study. From the date of HCTZ or ACEI dispensing, patients were followed until a SCC or BCC diagnosis requiring excision or topical chemotherapy treatment on or within 30 days after the diagnosis date; or a censoring event. Using Cox proportional hazards regression models, we estimated the hazard ratios (HRs), overall and separately by age, sex, and race. We also examined site- and age-adjusted incidence rate ratios (IRRs) by cumulative HCTZ dose within the matched cohort.