Regular inhaled corticosteroids in adult-onset asthma and the risk for future cancer: A population-based cohort study with proper person-time analysis

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Title:	Regular inhaled corticosteroids in adult-onset asthma and the risk for future cancer: A population-based cohort study with proper person-time analysis
Authors:	洪炯宗;C. Kok, Victor;Huang, Hsu-Kai;Chao, Tsung-Ming;Hong, Ya-Fang;Horng, Jorng-Tzong
Contributors:	資訊電機學院資訊工程學系
Keywords:	Asthma;Cancer;Chronic obstructive pulmonary disease;Cohort analysis;Corticosteroids;Datasets;Disease prevention;Drug therapy;Health insurance;Health risk assessment;immortal time bias;Immunomodulators;Inhaled medication;Lung cancer;Mortality;NHIRD;Original Research;Patient outcomes;Population-based studies;population-based study;Prevention;retrospective cohort study;risk of cancer
Date:	2015-03-26
Issue Date:	2026-04-23 13:59:36 (UTC+8)
Publisher:	Dove Medical Press Ltd.;New Zealand: Dove Medical Press Limited
Abstract:	摘要： Recent studies have shown that inhaled corticosteroids (ICS) can exert anti-inflammatory effects for chronic airway diseases, and several observational studies suggest that they play a role as cancer chemopreventive agents, particularly against lung cancer. We aimed to examine whether regular ICS use was associated with a reduced risk for future malignancy in patients with newly diagnosed adult-onset asthma. We used a population-based cohort study between 2001 and 2008 with appropriate person-time analysis. Participants were followed up until the first incident of cancer, death, or to the end of 2008. The Cox model was used to derive an adjusted hazard ratio (aHR) for cancer development. Kaplan-Meier cancer-free survival curves of two groups were compared. The exposed group of 2,117 regular ICS users and the nonexposed group of 17,732 non-ICS users were assembled. After 7,365 (mean, 3.5 years; standard deviation 2.1) and 73,789 (mean, 4.1 years; standard deviation 2.4) person-years of follow-up for the ICS users and the comparator group of non-ICS users, respectively, the aHR for overall cancer was nonsignificantly elevated at 1.33 with 95% confidence interval (CI), 1.00-1.76, P=0.0501. The Kaplan-Meier curves for overall cancer-free proportions of both groups were not significant (log-rank, P=0.065). Synergistic interaction of concurrent presence of regular ICS use was conducted using "ICS-negative and chronic obstructive pulmonary disease (COPD)-negative" as the reference. The aHR for the group of "ICS-positive, COPD-negative" did not reach statistically significant levels with aHR at 1.38 (95% CI, 0.53-3.56). There was a statistically significant synergistic interaction of concurrent presence of regular ICS use and COPD with aHR at 3.78 (95% CI, 2.10-6.81). The protective effect of regular ICS use in the studied East Asian patients with adult-onset asthma was not detectable, contrary to reports of previous studies that ICS might prevent the occurrence of future cancer. 其他題名： Ther Clin Risk Manag 出版者： New Zealand: Dove Medical Press Limited 出版日期： 2015-01-01 出處： Therapeutics and clinical risk management, 2015-01, Vol.11 (default), p.489-499 資源來源： Taylor & Francis Journals Auto-Holdings Collection 版權： COPYRIGHT 2015 Dove Medical Press Limited 版權： 2015. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 版權： 2015 Kok et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License 2015 識別號： ISSN: 1178-203X 識別號： ISSN: 1176-6336 識別號： EISSN: 1178-203X 識別號： DOI: 10.2147/TCRM.S80793 識別號： PMID: 25848295
Appears in Collections:	[Department of Computer Science and information Engineering] journal & Dissertation

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