Use of Inhaled Corticosteroids and the Risk of Lung Cancer, the HUNT Study
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.
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.
KeywordsCOPD ICS Lung cancer
We thank the staff at HUNT Research Center, Norwegian Cancer Registry and Statistics Norway for cooperation and help in data management, and, last but not least, all the participants in the HUNT Study.
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Compliance with Ethical Standards
Conflict of interest
The authors declare that they have no conflicts of interest.
Informed consent was obtained from all individual participants included in the study.
- 2.WHO (2014) World cancer report 2014. International Agency for Research on Cancer, LyonGoogle Scholar
- 3.Gomes M, Teixeira AL, Coelho A, Araújo A, Medeiros R (2014) The role of inflammation in lung cancer. In: Aggarwal BB, Sung B, Gupta SC (eds) Inflammation and cancer. advances in experimental medicine and biology, vol 816. Springer, BaselGoogle Scholar
- 7.Disease GIfCOP (2017) GOLD 2017 global strategy for the diagnosis, mangement, and prevention of chronic obstructive pulmonary disease http://goldcopd.org/2017
- 19.Pauwels RA, Lofdahl CG, Laitinen LA, Schouten JP, Postma DS, Pride NB et al (1999) Long-term treatment with inhaled budesonide in persons with mild chronic obstructive pulmonary disease who continue smoking. European Respiratory Society Study on Chronic Obstructive Pulmonary Disease. N Engl J Med 340(25):1948–1953CrossRefPubMedGoogle Scholar
- 20.Tashkin DP, Rennard SI, Martin P, Ramachandran S, Martin UJ, Silkoff PE et al (2008) Efficacy and safety of budesonide and formoterol in one pressurized metered-dose inhaler in patients with moderate to very severe chronic obstructive pulmonary disease: results of a 6-month randomized clinical trial. Drugs 68(14):1975–2000CrossRefPubMedGoogle Scholar
- 23.Norway CRo (2016) Cancer in Norway 2015—cancer incidence, mortality, survival and prevalence in Norway Oslo: Cancer Registry of Norway https://www.kreftregisteret.no/globalassets/cancer-in-norway/2015/cin_2015.pdf. Accessed 27 March 2017
- 25.Alberg A, Nonemaker J (2012) Who is at high risk for lung cancer? population-level and individual-level perspectives. Semin Respir Crit Care Med.Google Scholar
- 28.Godtfredsen N, Prescott E, Osler M (2005) Effect of smoking reduction on lung cancer risk. JAMA ;294Google Scholar
- 36.Earnings of all employees, 2016. Statistics Norway. 2016. https://www.ssb.no/en/arbeid-og-lonn/statistikker/lonnansatt. Accessed 28 March 2017
- 37.Level of education for men and woman 16 years and older. County of residence. Numbers and per cent. Statistics Norway. 2016. https://www.ssb.no/en/utdanning/statistikker/utniv/aar/2016-06-20?fane=tabell&sort=nummer&tabell=270245. Accessed 28 March 2017
- 38.Smoking habits, 2015. Statistics Norway. 2016 https://www.ssb.no/en/helse/statistikker/royk/aar/2016-01-14. Accessed 28 March 2017