Association of Spironolactone Use With Risk of Cancer: A Systematic Review and Meta-Analysis

    February 2022 in “ JAMA Dermatology
    Kanthi Bommareddy, Hassan Hamade, María A. López-Olivo, Mackenzie R. Wehner, Traci Tosh, John S. Barbieri
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    TLDR Spironolactone does not increase cancer risk and may lower prostate cancer risk, but more research is needed.
    A systematic review and meta-analysis of 7 observational studies, involving 4,528,332 individuals, found no significant increase in the risk of various types of cancer (breast, ovarian, bladder, kidney, gastric, or esophageal) associated with the use of spironolactone, a drug often used for acne, hidradenitis, androgenetic alopecia, and hirsutism. Interestingly, spironolactone use was linked to a decreased risk of prostate cancer. However, the certainty of the evidence was low due to potential limitations such as wide confidence intervals for rarer outcomes and the inability to examine dose-dependent associations. The study predominantly included older European individuals, which may not generalize to other populations or younger individuals. Future studies are needed, particularly among diverse populations such as younger individuals and those with acne or hirsutism.
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