@article {Suissa1901720，作者= {苏伊萨，萨米和戴尔{\ textquoteright} Aniello，柔。和Gonzalez，安V.和Ernst，皮尔}，标题= {吸入皮质类固醇的使用和肺癌中COPD发病}，体积={55}，数= {2}，elocation-ID = {1901720}，年= {2020}，DOI = {10.1183 / 13993003.01720-2019}，出版商= {欧洲呼吸协会}，抽象= {背景吸入皮质类188bet官网地址固醇（ICS）建议用于肺癌的潜在的化学预防。慢性阻塞性肺疾病（COPD）一些观察性研究报告不一致的结果，无论是在肺癌的发病率降低显著与ICS使用或没有影响。我们评估此关联，使用了一种方法，避免影响到一些偏见COPD患者，长效支气管扩张剂的新用户studies.Methods的队列超过2000 {\ textendash} 2014年，形成用魁北克医疗保健数据库，并遵循直到2015年肺癌的第一诊断。队列入境后1年的延迟来避免protopathic偏见和1年的潜伏期为ICS使用开始后包括在内。A time-dependent Cox regression model was used to estimate the hazard ratio (HR) of lung cancer associated with ICS exposure, adjusted for covariates.Results The cohort involved 63 276 subjects, including 63\% receiving ICS, with 3743 lung cancers occurring during a mean follow-up of 5 years. The adjusted HR of lung cancer associated with any ICS exposure was 1.01 (95\% CI 0.94{\textendash}1.08), relative to no ICS use. The HR with longer time (\>4 years) since ICS initiation was 0.92 (95\% CI 0.83{\textendash}1.03), while with higher mean daily ICS dose (\>1000 μg fluticasone equivalents) was 1.36 (95\% CI 1.03{\textendash}1.81).Conclusions Inhaled corticosteroid use is not associated with a reduction in lung cancer incidence in patients with COPD. Observational studies reporting such reduction may have been affected by time-related biases and the inclusion of patients with asthma. The proposition of a randomised trial warrants some caution.Large cohort study finds no reduction in lung cancer incidence with inhaled corticosteroids in COPD. Other observational studies reporting significant reductions probably affected by time-related biases and confounding from the inclusion of asthma patients. http://bit.ly/34Qeetd}, issn = {0903-1936}, URL = {//www.qdcxjkg.com/content/55/2/1901720}, eprint = {//www.qdcxjkg.com/content/55/2/1901720.full.pdf}, journal = {European Respiratory Journal} }