RT期刊论文SR电子T1吸入皮质类固醇的使用和肺癌中COPD JF欧洲呼吸杂志JO欧洲呼吸ĴFD欧洲呼吸协会SP 1901720发病DO 10.1183 / 13993003.01720-2019 VO 55 2 A1苏伊萨，萨米A1 Dell'Aniello，188bet官网地址柔A1冈萨雷斯，安V. A1恩斯特，皮尔YR 2020 UL //www.qdcxjkg.com/content/55/2/1901720.abstract AB背景吸入皮质类固醇（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，影响了一些COPD患者，长效支气管扩张剂的新用户超过2000-2014的studies.Methods的队列中避免偏见，使用魁北克医疗保健数据库成立，并随访至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 0.94–1.08), relative to no ICS use. The HR with longer time (>4 years) since ICS initiation was 0.92 (95% CI 0.83–1.03), while with higher mean daily ICS dose (>1000 μg fluticasone equivalents) was 1.36 (95% CI 1.03–1.81).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