title: Prescription diuretic use and risk of basal cell carcinoma in the nationwide U.S. radiologic technologists cohort.
abstract: BACKGROUND
  UV radiation (UVR) exposure is the primary risk factor for basal cell carcinoma (BCC). Although prescription diuretics have photosensitizing properties, the relationship between diuretic use and BCC remains unclear.
  
  
  METHODS
  Using data from the United States Radiologic Technologists Study, a large, nationwide prospective cohort, we assessed the relationship between diuretic use and first primary BCC while accounting for sun exposure history, constitutional characteristics, lifestyle factors, and anthropometric measurements for geographically dispersed individuals exposed to a wide range of ambient UVR.
  
  
  RESULTS
  After adjustment for potential confounders, we found a significantly increased risk of BCC associated with diuretic use [HR, 1.22; 95% confidence interval (CI), 1.07-1.38]. This relationship was modified by body mass index (P = 0.019), such that BCC risk was increased with diuretic use in overweight (HR, 1.43; 95% CI, 1.16-1.76) and obese individuals (HR, 1.43; 95% CI, 1.09-1.88), but not in normal weight individuals (HR, 0.99; 95% CI, 0.81-1.21).
  
  
  CONCLUSIONS
  Increased risk of BCC associated with diuretic use in overweight and obese participants may be related to higher dosages, longer duration of medication use, reduced drug metabolism, or drug interactions.
  
  
  CONCLUSIONS
  Future cohort studies should obtain more detailed information on medication use, consider factors that affect drug metabolism, and measure intermediate endpoints such as photosensitivity reactions.
authors.affiliation: Department of Epidemiology and Biostatistics, Indiana University, School of Public Health, Bloomington, Indiana; Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; and ecmcdona@indiana.edu.
authors.forename: Emily
authors.initials: E
authors.lastname: McDonald
authors.affiliation: Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; and.
authors.forename: D Michal
authors.initials: DM
authors.lastname: Freedman
authors.affiliation: Division of Environmental Health Sciences, University of Minnesota, School of Public Health, Minneapolis, Minnesota.
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Alexander
authors.affiliation: Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; and.
authors.forename: Michele M
authors.initials: MM
authors.lastname: Doody
authors.affiliation: Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; and.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Tucker
authors.affiliation: Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; and.
authors.forename: Martha S
authors.initials: MS
authors.lastname: Linet
authors.affiliation: Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH, Bethesda, Maryland; and.
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Cahoon
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002280:Basal Cell Carcinoma / Q000453:epidemiology*; D015331:Cohort Studies; D004232:Diuretics / Q000009:adverse effects*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D055553:Prescription Drugs / Q000009:adverse effects; D012307:Risk Factors; D012878:Skin Neoplasms / Q000453:epidemiology*; D014466:Ultraviolet Rays / Q000009:adverse effects
chemical_list: D004232:Diuretics; D055553:Prescription Drugs