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Rachel V Thomas

WHO Cancer Agency Flags 3 Common Medicines As Carcinogenic: What It Means For Millions Of Patients

The International Agency for Research on Cancer (IARC), the World Health Organization's (WHO) cancer research agency, has classified three widely used medicines—hydrochlorothiazide, voriconazole, and tacrolimus—as Group 1 carcinogens, meaning they are "carcinogenic to humans."

All three medicines are included on the WHO Model List of Essential Medicines and are prescribed to millions of people worldwide for treating hypertension, serious fungal infections, and preventing organ transplant rejection.

A Group 1 classification means there is sufficient scientific evidence that an agent can cause cancer in humans under certain circumstances. However, it does not indicate how likely a person is to develop cancer while taking the medicine as prescribed. The actual risk depends on factors such as the dose, duration of use, individual health, and other risk factors.

<h2>Which Medicines Have Been Classified as Carcinogenic?</h2>

Hydrochlorothiazide: It is a thiazide diuretic commonly prescribed to treat essential hypertension. Although newer blood pressure medications are increasingly used, it remains a widely prescribed treatment because of the global burden of hypertension.

Voriconazole: It is a broad-spectrum triazole antifungal medicine used to treat invasive aspergillosis and other serious fungal infections, particularly among transplant recipients and other immunocompromised patients.

Tacrolimus: It is an immunosuppressive medicine used to reduce the risk of organ rejection in adult and pediatric transplant recipients and to prevent graft-versus-host disease following stem cell transplantation. Topical tacrolimus is also used as a second-line treatment for atopic dermatitis and vitiligo when topical corticosteroids are unsuitable.

Also read: <a href="https://www.healthandme.com/health-news/ancient-inca-dna-reveals-smallpox-reached-americas-through-european-colonization-article-155238082" data-type="tilCustomLink">Ancient Inca DNA Reveals Smallpox Reached Americas Through European Colonization</a>

<h2>Why Did IARC Classify Them as Carcinogenic?</h2>

"The IARC Monographs Working Group reviewed evidence from epidemiological studies, cancer bioassays in experimental animals, and mechanistic studies to assess the carcinogenic hazard to humans of exposure to these agents and concluded that hydrochlorothiazide, tacrolimus, and voriconazole are all carcinogenic to humans (Group 1)," the IARC said.

<ul><li>Hydrochlorothiazide has been linked to squamous cell skin cancer and lip cancer because it increases the skin's sensitivity to sunlight.</li><li>Voriconazole is associated with squamous cell carcinoma of the skin through the phototoxic effects of one of its metabolites.</li><li>Tacrolimus has been linked to non-Hodgkin lymphoma and post-transplant lymphoproliferative disorders, largely due to its immune-suppressing effects.</li></ul>

<h2>What Does This Mean for Patients?</h2>

Dr. Shyam Aggarwal, Chairman, Medical Oncology, Sir Ganga Ram Hospital, told HealthandMe that the classification identifies a cancer hazard, not the level of cancer risk associated with normal therapeutic use.

"The IARC underlines that this Group 1 listing identifies a cancer hazard—the potential of an agent to cause malignancy rather than measuring how great the actual risk is when the medicines are taken at normal therapeutic doses. All three remain listed as essential medicines by WHO, reflecting their critical role in treating serious illness," he said.

Read More: <a href="https://www.healthandme.com/parenting/breastfeeding-can-help-reduce-mothers-risk-of-type-2-diabetes-breast-cancer-and-more-article-155272779" data-type="tilCustomLink">Breastfeeding Can Help Reduce Mothers' Risk of Type 2 Diabetes, Breast Cancer and More</a>

Dr. Aggarwal stressed that patients should not stop taking these medicines without consulting their doctor.

"Abruptly stopping any of these agents can result in dangerous rises in blood pressure, uncontrolled infection, or transplant failure. The recommended course is to speak with the treating physician, adopt rigorous sun-protection habits if taking hydrochlorothiazide or voriconazole, and maintain regular surveillance for those receiving tacrolimus after transplantation," he added.

Dr. Tushar Tayal, Associate Director – Internal Medicine, CK Birla Hospital, Gurugram, told HealthandMe the reclassification should not be a cause for alarm.

According to him, the concern relates to long-term cumulative exposure rather than a single dose. Stopping treatment abruptly could pose a much greater immediate risk, including uncontrolled hypertension, severe infection, or transplant rejection.

<ul><li>Do not stop or change your medication on your own.</li><li>Consult your treating physician before making any changes to your treatment.</li><li>Discuss whether regular skin examinations or an alternative treatment plan may be appropriate based on your individual risk.</li><li>Use sun protection if you are taking hydrochlorothiazide or voriconazole, as advised by your doctor.</li><li>Attend regular follow-up appointments, especially if you are taking tacrolimus after an organ transplant.</li></ul>

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IARC Flags Medicines As Carcinogenic

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The International Agency for Research on Cancer (IARC), the World Health Organization's (WHO) cancer research agency, has classified three widely used medicines—hydrochlorothiazide, voriconazole, and tacrolimus—as Group 1 carcinogens, meaning they are "carcinogenic to humans."All three medicines are included on the WHO Model List of Essential Medicines and are prescribed to millions of people worldwide for treating hypertension, serious fungal infections, and preventing organ transplant rejection.A Group 1 classification means there is sufficient scientific evidence that an agent can cause cancer in humans under certain circumstances. However, it does not indicate how likely a person is to develop cancer while taking the medicine as prescribed. The actual risk depends on factors such as the dose, duration of use, individual health, and other risk factors.Which Medicines Have Been Classified as Carcinogenic?Hydrochlorothiazide: It is a thiazide diuretic commonly prescribed to treat essential hypertension. Although newer blood pressure medications are increasingly used, it remains a widely prescribed treatment because of the global burden of hypertension.Voriconazole: It is a broad-spectrum triazole antifungal medicine used to treat invasive aspergillosis and other serious fungal infections, particularly among transplant recipients and other immunocompromised patients.Tacrolimus: It is an immunosuppressive medicine used to reduce the risk of organ rejection in adult and pediatric transplant recipients and to prevent graft-versus-host disease following stem cell transplantation. Topical tacrolimus is also used as a second-line treatment for atopic dermatitis and vitiligo when topical corticosteroids are unsuitable.Also read: Ancient Inca DNA Reveals Smallpox Reached Americas Through European ColonizationWhy Did IARC Classify Them as Carcinogenic?"The IARC Monographs Working Group reviewed evidence from epidemiological studies, cancer bioassays in experimental animals, and mechanistic studies to assess the carcinogenic hazard to humans of exposure to these agents and concluded that hydrochlorothiazide, tacrolimus, and voriconazole are all carcinogenic to humans (Group 1)," the IARC said.Hydrochlorothiazide has been linked to squamous cell skin cancer and lip cancer because it increases the skin's sensitivity to sunlight.Voriconazole is associated with squamous cell carcinoma of the skin through the phototoxic effects of one of its metabolites.Tacrolimus has been linked to non-Hodgkin lymphoma and post-transplant lymphoproliferative disorders, largely due to its immune-suppressing effects.What Does This Mean for Patients?Dr. Shyam Aggarwal, Chairman, Medical Oncology, Sir Ganga Ram Hospital, told HealthandMe that the classification identifies a cancer hazard, not the level of cancer risk associated with normal therapeutic use."The IARC underlines that this Group 1 listing identifies a cancer hazard—the potential of an agent to cause malignancy rather than measuring how great the actual risk is when the medicines are taken at normal therapeutic doses. All three remain listed as essential medicines by WHO, reflecting their critical role in treating serious illness," he said.Read More: Breastfeeding Can Help Reduce Mothers' Risk of Type 2 Diabetes, Breast Cancer and MoreDr. Aggarwal stressed that patients should not stop taking these medicines without consulting their doctor."Abruptly stopping any of these agents can result in dangerous rises in blood pressure, uncontrolled infection, or transplant failure. The recommended course is to speak with the treating physician, adopt rigorous sun-protection habits if taking hydrochlorothiazide or voriconazole, and maintain regular surveillance for those receiving tacrolimus after transplantation," he added.No Need to PanicDr. Tushar Tayal, Associate Director – Internal Medicine, CK Birla Hospital, Gurugram, told HealthandMe the reclassification should not be a cause for alarm.According to him, the concern relates to long-term cumulative exposure rather than a single dose. Stopping treatment abruptly could pose a much greater immediate risk, including uncontrolled hypertension, severe infection, or transplant rejection.What Should Patients Do?Do not stop or change your medication on your own.Consult your treating physician before making any changes to your treatment.Discuss whether regular skin examinations or an alternative treatment plan may be appropriate based on your individual risk.Use sun protection if you are taking hydrochlorothiazide or voriconazole, as advised by your doctor.Attend regular follow-up appointments, especially if you are taking tacrolimus after an organ transplant.

who cancer agency flags 3 common medicines as carcinogenic: what it means for millions of patients

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