Spironolactone use not linked to increased risk for cancer

Spironolactone use is not associated with an increased risk for cancer, according to a systematic review and meta-analysis published online Feb. 9 in JAMA Dermatology.

Kanthi Bommareddy, M.D., from the University of Miami Miller School of Medicine in Fort Lauderdale, Florida, and colleagues conducted a systematic review to examine the pooled occurrence of cancers, particularly breast and prostate cancers, among individuals treated with spironolactone. Data were included for seven studies, with a total population of 4,528,332 individuals (mean age, 62.6 to 72.0 years).

The studies were all considered to have a low risk for bias. The researchers observed no association between spironolactone use and risk for breast cancer (risk ratio, 1.04; 95% confidence interval, 0.86 to 1.22). Spironolactone use was associated with a reduced risk for prostate cancer (risk ratio, 0.79; 95% confidence interval, 0.68 to 0.90). No significant associations were observed between use of spironolactone and risks for ovarian cancer, bladder cancer, kidney cancer, gastric cancer, or esophageal cancer.

"This systematic review and meta-analysis provides reassuring data that use of spironolactone, an important treatment for patients with acne, hidradenitis, androgenetic alopecia, and hirsutism, is unlikely to be associated with a substantial increased risk of cancer," the authors write. "However, the certainty of the evidence was low. Future studies are needed, particularly among diverse populations such as younger individuals and those with acne or hirsutism."