ArticleThe European respiratory journal2020
Inhaled corticosteroid use and the incidence of lung cancer in COPD.
Article in The European respiratory journal, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
14 citing papers in PubMed, 3 syntheses or guidelines pooled it, 25 citations in OpenAlex.
- Chronic Obstructive Pulmonary Disease and Lung Cancer: A Meta-Analysis of Risk Association.International journal of chronic obstructive pulmonary disease · 2025Pooled it
- Inhaled corticosteroids, COPD, and the incidence of lung cancer: a systematic review and dose response meta-analysis.BMC pulmonary medicine · 2022Pooled it
- Inhaled Corticosteroids and the Risk of Lung Cancer in Chronic Obstructive Pulmonary Disease Patients: A Systematic Review and Meta-Analysis.Pulmonary medicine · 2022Pooled it
- Moving Past Just Confidence Intervals: Why We Need Stronger Heterogeneity Assessment in Lung Cancer Meta-Analyses? [Letter].International journal of chronic obstructive pulmonary disease · 2026Article
- Effect of Exposure to Inhaled Corticosteroids on Lung Cancer Incidence - A Comparison of Earlier Study Methodology on the Financial Database of the Hungarian National Health Insurance Fund.International journal of chronic obstructive pulmonary disease · 2026Article
- Construction of a novel tool for predicting chronic obstructive pulmonary disease mortality in lung cancer patients.Scientific reports · 2025Article
- Impact of asthma and/or chronic obstructive pulmonary disease on the survival of patients with lung adenocarcinoma.Therapeutic advances in medical oncology · 2025Article
- The effect of inhaler prescription on the development of lung cancer in COPD: a nationwide population-based study.Respiratory research · 2024Article
- Pharmacological therapy for stable chronic obstructive pulmonary disease.Chronic diseases and translational medicine · 2023Review
- A Critical Systematic Review for Inhaled Corticosteroids on Lung Cancer Incidence: Not Yet Concluded Story.Tuberculosis and respiratory diseases · 2023Article
- Differences in severe exacerbations rates and healthcare utilisation in COPD populations in the UK and France.BMJ open respiratory research · 2022Article
- Inhaled corticosteroids and risk of lung cancer among chronic obstructive pulmonary disease patients: a comprehensive analysis of nine prospective cohorts.Translational lung cancer research · 2021Article
- Current developments and future directions in COPD.European respiratory review : an official journal of the European Respiratory Society · 2020Article
- Integrating Comorbidities and Phenotype-Based Medicine in Patient-Centered Medicine in COPD.Journal of clinical medicine · 2020Review
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4 authors at 1 institution in 1 country.
Funding
Abstract
backgroundInhaled corticosteroids (ICS) are suggested for potential chemoprevention of lung cancer. Several observational studies in patients with chronic obstructive pulmonary disease (COPD) reported inconsistent results, either significant reductions in lung cancer incidence with ICS use or no effect. We assessed this association, using an approach that avoided biases affecting some of the studies.
methodsA cohort of patients with COPD, new users of long-acting bronchodilators over 2000-2014, was formed using the Quebec healthcare databases, and followed until 2015 for a first diagnosis of lung cancer. A 1-year delay after cohort entry was used to avoid protopathic bias and a 1-year latency period was included after the initiation of ICS use. A time-dependent Cox regression model was used to estimate the hazard ratio (HR) of lung cancer associated with ICS exposure, adjusted for covariates.
resultsThe 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).
conclusionsInhaled 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.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.