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Corticosteroid dose increase associated with risk for lung SCC in patients with asthma, COPD

Although patients with squamous cell carcinoma and asthma or chronic obstructive pulmonary disease did not decrease their risk for lung squamous cell carcinoma through corticosteroid use, a recent increase in corticosteroid dose was associated with an increased risk for lung squamous cell carcinoma, according to recent research.

“The use of corticosteroids in patients with asthma and COPD was associated with lung [squamous cell carcinoma (SCC)], especially in men,” Zhi Hong Jian, MD, PhD, from the department of public health and Institute of Public Health, at Chung Shan Medical University in Taichung, Taiwan, and colleagues wrote. “Recent dose increase in corticosteroids was associated with SCC. Lung cancer screening is necessary when treatment goals for asthma or COPD are not being met or when patients are not responding to current therapy.”

Jian and colleagues evaluated 793 patients with lung SCC who also had asthma or COPD. Patients received either a low or high dose of inhaled corticosteroids (ICS) or low or high oral corticosteroids. For every patient with lung SCC, Jian and colleagues recruited four age- and sex-matched control patients (n = 3,172) who had a similar time to asthma or COPD diagnosis, according to the abstract.

The researchers found a 2.18 odds ratio (OR) for developing SCC in men (95% CI, 1.56-3.04) with a high dose of ICS and a 1.77 OR for men with a low dose of ICS (95% CI, 1.22-2.57). For OCS doses, researchers observed a 1.55 OR (95% CI, 1.22-1.98) for developing SCC for men who took a high dose and a 1.46 OR (1.16-1.84) for men receiving a low dose.

For women in the study, there was no significant association with ICS or OCS dose and risk for SCC.

Risk for SCC and dose increase was also examined for all groups. Men taking a high dose of both ICS and OCS had an 8.08 OR (95% CI, 3.22-20.30) for developing SCC, a 4.49 OR (95% CI, 2.05-9.85) when taking ICS alone and a 3.54 OR (95% CI, 2.50-5.01) when taking OCS alone, according to the abstract.

For women in the study, taking high doses of OCS yielded a 6.72 OR (95% CI, 2.69-16.81). – by Jeff Craven

Disclosure: The researchers report no relevant financial disclosures.