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William J. Gradishar, MD, FACP, FASCO

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Is the Acne Medication Spironolactone Linked to Increased Risk for Breast Cancer?

By: Joseph Fanelli
Posted: Monday, April 25, 2022

According to a systematic review and meta-analysis of spironolactone use presented in JAMA Dermatology, consumption of the acne treatment does not appear to be associated with a meaningful increase in the risk for breast cancer or other solid tumors. The use of spironolactone seemed to be associated with a decreased risk for prostate cancer, however, according to Maria A. Lopez-Olivio, MD, PhD, MSc, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues. “However, the certainty of the evidence was low, and future studies are needed, including among diverse populations such as younger individuals and those with acne or hirsutism,” the authors explained.

In this study, two independent reviewers selected studies that reported the occurrence of cancer in men and women at least 18 years old who were exposed to spironolactone. Seven studies met eligibility criteria, with sample sizes ranging from 18,036 to 2.3 million and a total population of 4,528,332 patients.

The researchers observed no statistically significant association between the use of spironolactone and the risk of breast cancer (risk ratio = 1.04). They did, however, observe a correlation between spironolactone use and a decreased risk of prostate cancer (risk ratio = 0.79).

In addition, there was also no statistically significant association found between spironolactone exposure and the risk of ovarian cancer (risk ratio = 1.52), bladder cancer (risk ratio = 0.89), kidney cancer (risk ratio = 0.96), gastric cancer (risk ratio = 1.02), and esophageal cancer (risk ratio = 1.09).

“These data are reassuring that treatment with spironolactone is unlikely to be associated with a meaningful increased risk of cancer when prescribed at typical clinical doses,” the study authors commented.

Disclosure: For a full disclosure of the study authors, visit jamanetwork.com.


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