Vancouver, British Columbia—Patients with chronic obstructive pulmonary disease (COPD) depend on their steroid inhalers to keep airways open and allow them to breathe. They may also be getting another benefit: a reduction in risk for lung cancer.

In fact, a report in the European Respiratory Journal suggested the medicated devices could lower that risk as much as 30%.

To reach that conclusion, University of British Columbia–led researchers evaluated medical and pharmacy data over a decade for nearly 40,000 adults in British Columbia who were diagnosed with COPD. Of those, 994 also were later diagnosed with lung cancer.

The study team compared outcomes for people who took inhaled steroids versus those who used beta agonists, another class of drugs used to treat COPD. While beta agonists, which relax muscles in the lungs to widen the airways, usually are first-line treatment for COPD, steroids, which reduce the number of inflammatory cells called eosinophils in the lungs, often are prescribed in more severe cases.

“Results showed that if you had COPD and consistently used a steroid inhaler, your chances of getting lung cancer were between 25 per cent and 30 per cent lower compared to people who took other treatments,” said study author Larry Lynd, PhD, BSP, who leads the Collaboration for Outcomes Research and Evaluation project at UBC’s faculty of pharmaceutical sciences and is an associate member of the faculty of medicine.

For the cohort, average age 70.7 years and 53% female, exposure to corticosteroids was associated with a 30% reduced risk of lung cancer (HR, 0.70; 95% CI, 0.61-0.80). ICS exposure was associated with a decrease in the risk of lung cancer diagnosis over five different methods of quantifying exposure, according to study authors, who conclude, “This population-based study suggests that ICS use reduces the risk of lung cancer in COPD patients.”

“More work is clearly needed to understand the exact nature of the relationship between lung cancer risks and steroid use,” Lynd added. “Over the next few months, we will find out which COPD patients would benefit the most from inhaled steroids.”

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