Awareness and Counseling Among Dermatologists of the Association Between Hydrochlorothiazide and Nonmelanoma Skin Cancer: Barriers and Opportunities

BACKGROUND Cumulative hydrochlorothiazide (HCTZ) use is linked to the development of nonmelanoma skin cancers. In August 2020, the U.S. FDA approved changes to the HCTZ drug label to indicate this. OBJECTIVE To uncover what proportion of dermatologists are aware of this association and how often screening and counseling are performed. MATERIALS AND METHODS An observational, cross-sectional survey assessing risk awareness and counseling frequency and barriers was distributed among academic dermatologists. Chi-square tests compared resident and attending respondent data. RESULTS A total of 83 respondents completed the questionnaire; most endorsed awareness of the association between HCTZ use and nonmelanoma skin cancer development before the survey, yet only 28.9% of respondents were aware of changes to the HCTZ drug label. A greater proportion of attendings than residents were aware of the association and drug label changes. The most reported barrier to counseling was the lack of specific screening guidelines for patients taking HCTZ. CONCLUSION Concerted efforts should be made in residency training and continuing medical education to ensure dermatologists are aware of this well-established link. Specialty-specific efforts should be made to implement clear guidelines on best screening practices and optimized counseling strategies for patients taking HCTZ.