The Faculty of Medicine and Health Sciences, NTNU, 7006, Trondheim, Norway.
Department of Pulmonology, St. Olavs Hospital HF, 7006, Trondheim, Norway.
Lung. 2018 Apr;196(2):179-184. doi: 10.1007/s00408-018-0092-z. Epub 2018 Feb 9.
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.
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.
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.
ICS use is not associated with a reduced risk of lung cancer in our study population.
炎症在慢性阻塞性肺疾病和肺癌的发生发展中起着核心作用。吸入性皮质类固醇（ICS）可减轻炎症。本研究调查了 ICS 的使用是否与肺癌风险降低相关。
从 Nord-Trøndelag 健康研究（HUNT2 调查，1995-1997 年）的数据与挪威癌症登记处和挪威死因登记处合并。在总共 65215 名参与者中，包括那些存在慢性气道炎症的患者，其定义为 FEV1% < 70 和/或慢性咳嗽和咳痰（N = 4136）。其中，有 3041 名患者报告了 ICS 的使用情况，并观察了 12 年。使用 Cox 回归模型计算肺癌风险，95%置信区间（CI），性别、年龄、吸烟包年数和 FEV1% < 70 作为已知混杂因素。
在 ICS 使用者（N = 1095）中，我们发现肺癌的发病率更高，但无统计学意义，N = 39（3.6%），而未使用者（N = 1946）中，N = 65（3.3%）。年龄和吸烟与更高的风险相关，而性别和肺功能则没有。调整混杂因素后，ICS 使用并未改变肺癌的风险，危险比（HR）为 0.968（95%CI，0.608-1.540），p 值为 0.890。
在我们的研究人群中，ICS 使用与肺癌风险降低无关。
