Use of Inhaled Corticosteroids and the Risk of Lung Cancer, the HUNT Study

Lung. 2018 Apr;196(2):179-184. doi: 10.1007/s00408-018-0092-z. Epub 2018 Feb 9.

Abstract

Background: Inflammation plays a central role in chronic obstructive pulmonary disease and lung cancer carcinogenesis. Inhaled corticosteroids (ICS) reduce inflammation. This study has investigated whether ICS use is associated with a lower risk of lung cancer.

Materials and methods: Data from the Nord-Trøndelag Health Study (HUNT2 Survey, 1995-1997) were merged with The Cancer Registry of Norway and Norwegian Cause of Death Registry. From a total of 65,215 participants, those with chronic airway inflammation, defined by FEV1% < 70 and/or chronic cough and expectorate phlegm, were included (N = 4136). Of these, 3041 individuals reported regarding ICS use and were observed for a period of 12 years. Cox regression models were used to calculate the risk of lung cancer with a 95% confidence interval (CI) with sex, age, smoking pack years and FEV1% < 70 as known confounders.

Results: Among ICS users (N = 1095). we found a higher, but not significant, incidence of lung cancer N = 39 (3.6%), compared to non-users (N = 1946) with N = 65 (3.3%) cases. Age and smoking were associated with a higher risk, while sex and lung function were not. After adjusting for confounders, ICS use did not change the risk of lung cancer, hazard ratio (HR) 0.968, (95% CI, 0.608-1.540), and p value 0.890.

Conclusion: ICS use is not associated with a reduced risk of lung cancer in our study population.

Keywords: COPD; ICS; Lung cancer.

MeSH terms

  • Administration, Inhalation
  • Adrenal Cortex Hormones / administration & dosage*
  • Adrenal Cortex Hormones / adverse effects
  • Age Factors
  • Aged
  • Databases, Factual
  • Female
  • Forced Expiratory Volume
  • Humans
  • Incidence
  • Lung / drug effects*
  • Lung / physiopathology
  • Lung Neoplasms / chemically induced
  • Lung Neoplasms / diagnosis
  • Lung Neoplasms / epidemiology*
  • Male
  • Middle Aged
  • Norway / epidemiology
  • Prevalence
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Registries
  • Risk Assessment
  • Risk Factors
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Time Factors
  • Treatment Outcome

Substances

  • Adrenal Cortex Hormones