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Post-inhaled corticosteroid pulmonary tuberculosis and pneumonia increases lung cancer in patients with COPD.
BMC Cancer 2016; 16(1):778BC

Abstract

BACKGROUND

Inhaled corticosteroids (ICS) have been associated with decreased lung cancer risk. However, they have been associated with pulmonary infections (tuberculosis [TB] and pneumonia) in patients with chronic obstructive pulmonary disease (COPD). TB and pneumonia have increased lung cancer risk. The association between post-ICS pulmonary infections and lung cancer remains unclear.

METHODS

We conducted a retrospective cohort study from 2003 to 2010 using the Taiwan National Health Insurance Research Database. Among the 1,089,955 patients with COPD, we identified 8813 new users of ICS prescribed for a period of 3 months or more and 35,252 non-ICS users who were randomly matched for sex, age and date of ICS use from 2003 to 2005. Cox proportional hazard regression was used to estimate the hazard ratio (HR) of pulmonary infections in patients with/without ICS use.

RESULTS

The HRs for lung cancer in ICS users with sequential lung infections were as follows; 2.42 (95 % confidence interval [CI], 1.28-4.58) for individuals with TB, 2.37 (95 % CI, 1.01-5.54) for TB and pneumonia, and 1.17(95 % CI, 0.69-1.98) for those with pneumonia. For non-ICS users with pulmonary infections, the HRs were 1.68 (95 % CI, 0.78-3.65) for individual with TB and pneumonia, 1.42 (95 % CI, 0.89-2.26) for TB, and 0.95 (95 % CI, 0.62-1.46) for individuals with pneumonia.

CONCLUSIONS

COPD patients with TB /or pneumonia who used ICS had increased risk of lung cancer. Because the overall prognosis of lung cancer remains poor, screening tests are recommended for patients with these conditions.

Authors+Show Affiliations

School of Medicine, Chung Shan Medical University, Taichung City, Taiwan. Divisions of Medical Oncology and Pulmonary Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan.Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan.Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan.Office of Physical Education, Chung Yuan Christian University, Taoyuan City, Taiwan.Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan.Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan. Department of Neurology, Lu-Tung Christian Hospital, Changhua, Taiwan.Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan.Department of Physical Education, Fu Jen Catholic University, New Taipei City, Taiwan.Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan. Department of Family and Community Medicine, Chung Shan Medical University Hospital, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan.School of Medicine, Chung Shan Medical University, Taichung City, Taiwan. Department of Pediatrics, Chung Shan Medical University Hospital, Taichung City, Taiwan.Office of Physical Education, Chung Yuan Christian University, Taoyuan City, Taiwan.Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan. Liawyp@csmu.edu.tw. Department of Family and Community Medicine, Chung Shan Medical University Hospital, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan. Liawyp@csmu.edu.tw.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27724847

Citation

Wu, Ming-Fang, et al. "Post-inhaled Corticosteroid Pulmonary Tuberculosis and Pneumonia Increases Lung Cancer in Patients With COPD." BMC Cancer, vol. 16, no. 1, 2016, p. 778.
Wu MF, Jian ZH, Huang JY, et al. Post-inhaled corticosteroid pulmonary tuberculosis and pneumonia increases lung cancer in patients with COPD. BMC Cancer. 2016;16(1):778.
Wu, M. F., Jian, Z. H., Huang, J. Y., Jan, C. F., Nfor, O. N., Jhang, K. M., ... Liaw, Y. P. (2016). Post-inhaled corticosteroid pulmonary tuberculosis and pneumonia increases lung cancer in patients with COPD. BMC Cancer, 16(1), p. 778.
Wu MF, et al. Post-inhaled Corticosteroid Pulmonary Tuberculosis and Pneumonia Increases Lung Cancer in Patients With COPD. BMC Cancer. 2016 10 10;16(1):778. PubMed PMID: 27724847.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Post-inhaled corticosteroid pulmonary tuberculosis and pneumonia increases lung cancer in patients with COPD. AU - Wu,Ming-Fang, AU - Jian,Zhi-Hong, AU - Huang,Jing-Yang, AU - Jan,Cheng-Feng, AU - Nfor,Oswald Ndi, AU - Jhang,Kai-Ming, AU - Ku,Wen-Yuan, AU - Ho,Chien-Chang, AU - Lung,Chia-Chi, AU - Pan,Hui-Hsien, AU - Wu,Min-Chen, AU - Liaw,Yung-Po, Y1 - 2016/10/10/ PY - 2016/03/31/received PY - 2016/10/05/accepted PY - 2016/10/12/entrez PY - 2016/10/12/pubmed PY - 2017/9/28/medline KW - Chronic obstructive pulmonary disease KW - Inhaled corticosteroid KW - Pneumonia KW - Tuberculosis SP - 778 EP - 778 JF - BMC cancer JO - BMC Cancer VL - 16 IS - 1 N2 - BACKGROUND: Inhaled corticosteroids (ICS) have been associated with decreased lung cancer risk. However, they have been associated with pulmonary infections (tuberculosis [TB] and pneumonia) in patients with chronic obstructive pulmonary disease (COPD). TB and pneumonia have increased lung cancer risk. The association between post-ICS pulmonary infections and lung cancer remains unclear. METHODS: We conducted a retrospective cohort study from 2003 to 2010 using the Taiwan National Health Insurance Research Database. Among the 1,089,955 patients with COPD, we identified 8813 new users of ICS prescribed for a period of 3 months or more and 35,252 non-ICS users who were randomly matched for sex, age and date of ICS use from 2003 to 2005. Cox proportional hazard regression was used to estimate the hazard ratio (HR) of pulmonary infections in patients with/without ICS use. RESULTS: The HRs for lung cancer in ICS users with sequential lung infections were as follows; 2.42 (95 % confidence interval [CI], 1.28-4.58) for individuals with TB, 2.37 (95 % CI, 1.01-5.54) for TB and pneumonia, and 1.17(95 % CI, 0.69-1.98) for those with pneumonia. For non-ICS users with pulmonary infections, the HRs were 1.68 (95 % CI, 0.78-3.65) for individual with TB and pneumonia, 1.42 (95 % CI, 0.89-2.26) for TB, and 0.95 (95 % CI, 0.62-1.46) for individuals with pneumonia. CONCLUSIONS: COPD patients with TB /or pneumonia who used ICS had increased risk of lung cancer. Because the overall prognosis of lung cancer remains poor, screening tests are recommended for patients with these conditions. SN - 1471-2407 UR - https://www.unboundmedicine.com/medline/citation/27724847/Post_inhaled_corticosteroid_pulmonary_tuberculosis_and_pneumonia_increases_lung_cancer_in_patients_with_COPD_ L2 - https://bmccancer.biomedcentral.com/articles/10.1186/s12885-016-2838-4 DB - PRIME DP - Unbound Medicine ER -