Abstract
Inhaled corticosteroids (ICSs) are often prescribed in patients with chronic obstructive pulmonary disease (COPD). Their impact on the risk of lung cancer, a leading cause of mortality in COPD patients, remains uncertain.
Population-based linked administrative data between the years 1997 and 2007 from the province of British Columbia, Canada, were used to evaluate the association between lung cancer risk and ICS use in COPD patients. COPD was defined on the basis of receipt of three COPD-related prescriptions in subjects ≥50 years of age. Exposure to ICS was incorporated into multivariable Cox regression models using several time-dependent methods (“ever” exposure, cumulative duration of use, cumulative dose, weighted cumulative duration of use and weighted cumulative dose).
There were 39 676 patients who met the inclusion criteria. The mean±sd age of the cohort was 70.7±11.1 years and 53% were female. There were 994 (2.5%) cases of lung cancer during follow-up. In the reference case analysis (time-dependent “ever” exposure), ICS exposure was associated with a 30% reduced risk of lung cancer (HR 0.70 (95% CI 0.61–0.80)). ICS exposure was associated with a decrease in the risk of lung cancer diagnosis over all five methods of quantifying exposure.
This population-based study suggests that ICS use reduces the risk of lung cancer in COPD patients.
Abstract
Inhaled corticosteroid use appears to reduce the risk of lung cancer in a population-based cohort of COPD patients http://ow.ly/UuDZ30o7Bdi
Footnotes
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Conflict of interest: A.J.N. Raymakers has nothing to disclose.
Conflict of interest: M. Sadatsafavi has nothing to disclose.
Conflict of interest: D.D. Sin reports grants and personal fees for advisory board work, speaking engagements and organising education from AstraZeneca, grants and personal fees for advisory board work and organising meetings from Boehringer Ingelheim, grants from Merck Frosst, and personal fees for advisory board work from Novartis, outside the submitted work.
Conflict of interest: J.M. FitzGerald has nothing to disclose.
Conflict of interest: C.A. Marra has nothing to disclose.
Conflict of interest: L.D. Lynd reports grants from Canadian Institute for Health Research, during the conduct of the study; and grants from AstraZeneca, outside the submitted work.
Support statement: This study was supported by the Canadian Institutes of Health Research (CIHR; grant MOP-89865). All inferences, opinions and conclusions drawn in this article are those of the authors, and do not reflect the opinions or policies of the Population Data BC Data Steward(s). Funding information for this article has been deposited with the Crossref Funder Registry.
- Received July 5, 2018.
- Accepted March 13, 2019.
- Copyright ©ERS 2019