Inhaled corticosteroids have a protective effect against lung cancer in female patients with chronic obstructive pulmonary disease: a nationwide population-based cohort study

Liu, Shih-Feng; Kuo, Ho-Chang; Lin, Meng-Chih; Ho, Shinn‐Ying; Tu, Mei-Lien; Fang, Wen‐Feng; Wang, Chin‐Chou; Liu, Guan-Heng

doi:10.18632/oncotarget.15386

Cited by 30 publications

(32 citation statements)

References 62 publications

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“…In that study, ICS exposure was associated with a trend in favour of diminished cancer mortality. The beneficial effect appears to be dose-dependent, and perhaps more noticeable in women and former smokers [10,15]. It has also been reported in asthmatic patients [16].…”

mentioning

confidence: 79%

New evidence on the chemoprevention of inhaled steroids and the risk of lung cancer in COPD

2019

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confidence: 79%

New evidence on the chemoprevention of inhaled steroids and the risk of lung cancer in COPD

2019

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“…Similarly, Liu et al, report the ICSs (e.g. > 0.0395 gram) have the impact on attenuation of the chronic system inflammation in the COPD support this finding [ 53 ].…”

Section: Discussionmentioning

confidence: 73%

Effect of the asthma-chronic obstructive pulmonary disease syndrome on the stroke, Parkinson's disease, and dementia: a national cohort study

et al. 2017

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BackgroundTo evaluate the association of asthma–chronic obstructive pulmonary disease syndrome (ACOS) with neurodegenerative diseases (stroke, Parkinson's disease and dementia) and the role of the steroids in the neurodegenerative diseases among the ACOS cohort.Materials and MethodsComparison of the ACOS cohort (N = 10,260) with the non-ACOS cohort (n = 20,513) based on the patients aged ≧40 years in the National Health Insurance Research Database from January 1, 2000 to December 31, 2010. These patients follow up to diagnosis of neurodegenerative diseases or the December 31, 2011; using multivariable Cox proportional hazards models.ResultsAfter adjustment for potential confounders, the [adjusted hazard ratio (aHR), 95% confidence interval (CI)] in the ACOS cohort were [1.39, 1.28–1.50] [1.56, 1.34–1.81] and [1.43, 1.29–1.59] for stroke, Parkinson's disease, dementia; respectively. The [aHR, 95% CI] for ACOS cohort with (inhaler corticosteroids ≧0.13 gram/ oral steroids ≧0.08gram) were with less risk (all aHR<1, p values <0.05) for these 3 neurodegenerative diseases except Parkinson's disease with inhaler corticosteroids >0.43 gram. The risk of stroke and dementia were the lower in patients with < 250 μg/d of a fluticasone equivalent inhaler corticosteroids (aHR = 0.53, 95% CI = 0.35–0.79; aHR = 0.53, 95% CI = 0.31–0.90, respectively).ConclusionsThe ACOS cohort had a higher risk of the neurodegenerative diseases. The lower dose of the inhaler corticosteroids with cumulative dose ≧0.13 gram have the less risk of stroke and dementia.

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“…A recent study suggested that ICS has a potential role in lung cancer prevention among female COPD patients in Taiwan. 11 However, there are a few limitations of these previous studies, including a relatively short follow-up period. 8,10 In the year of inhaler initiation.…”

Section: Discussionmentioning

confidence: 96%

Inhaled corticosteroids in COPD and the risk of lung cancer

Lee

Kim

Lee

et al. 2018

Intl Journal of Cancer

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Inhaled corticosteroids (ICS) might reduce the risk of lung cancer by controlling airway inflammation in patients with chronic obstructive pulmonary disease (COPD) because both are associated with chronic inflammation. The objective was to assess the impact of ICS on lung cancer risk reduction in COPD patients. We performed a nested case-control study based on the database of the National Health Insurance Service-National Sample Cohort, a nationally representative cohort of 1,125,691 participants in Korea followed over 11 years. The eligible population was patients aged 30-89 years who were newly diagnosed with COPD and initiated inhaled medications after diagnosis. Cases were defined as individuals diagnosed with lung cancer after the initiation of inhaled medications and were matched with controls by propensity score at a 1:4 ratio. We identified 265 individuals with lung cancer, matched with 1,060 controls. Use of ICS was associated with reduced risk of lung cancer (adjusted hazard ratio [aHR] 0.74, 95% CI 0.57-0.96). The high cumulative ICS dose group, defined as those above the third quartile of ICS dose distribution, had a lower risk of lung cancer than the low cumulative dose group (aHR 0.51, 95% CI 0.34-0.75). The effect of ICS on lung cancer risk reduction was more remarkable in former smokers than current smokers. Additionally, the result was consistent in men regardless of the classification according to ICS use, while it was not significant in women. ICS, particularly at high cumulative dose, might be associated with decreased risk of lung cancer in patients with COPD. Severe COPD frequently warrants treatment with inhaled corticosteroids, which exert immunomodulatory and antiproliferative effects. Despite an association between COPD and increased lung cancer risk, patients on ICS appear to have a reduced likelihood of developing lung cancer. Here, analyzing data from the National Health Insurance Service-National Sample Cohort in Korea, the authors show that ICS use is associated with decreased lung cancer risk in COPD patients. An inverse dose-response relationship was detected, whereby increasing cumulative ICS dose was associated with decreasing lung cancer risk. The effect was most pronounced in men and former smokers.

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Inhaled corticosteroids have a protective effect against lung cancer in female patients with chronic obstructive pulmonary disease: a nationwide population-based cohort study

Cited by 30 publications

References 62 publications

New evidence on the chemoprevention of inhaled steroids and the risk of lung cancer in COPD

New evidence on the chemoprevention of inhaled steroids and the risk of lung cancer in COPD

Effect of the asthma-chronic obstructive pulmonary disease syndrome on the stroke, Parkinson's disease, and dementia: a national cohort study

Inhaled corticosteroids in COPD and the risk of lung cancer

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