Review Article

Inhaled Corticosteroids and the Risk of Lung Cancer in Chronic Obstructive Pulmonary Disease Patients: A Systematic Review and Meta-Analysis

Table 1

Description of included studies in ICS use and the risk of lung cancer in COPD patients.

Author-yearCountryDesign/study periodMean follow-up in Sample sizeTreatmentLatency period (years)Adjusted for

Parimon et al. 2007 [30]USACohort
1996-2001
3.84 (2.08-4.29)t
c
517t
9957c
Triamcinolone, beclomethasone, flunisolide, fluticasone1Age, smoking status, smoking intensity, history of non-lung-cancer malignancy, coexisting illness, bronchodilator use
Raymekers et al. 2009 [43]CanadaCohort
1997-2007
28314t
11312c
ICS1Age, sex, neighborhood income quartile, regional health service, prescriptions filled, hospitals encountered, inpatient hospital stays, physician encounters, comorbidity
Suissa et al. 2019 [44]CanadaCohort
2000-2014
4.958177Triamcinolone, beclomethasone, flunisolide, fluticasone, budesonide, mometasone, ciclesonide1Age, sex, COPD hospitalizations and exacerbations in the prior year, comorbidity including CVD, DM, renal diseases, other cancers, dementia, rheumatic diseases
Lee et al. 2013 [45]KoreaCase-control
2007-2010
368.7t
68.1c
9177t
37048c
Triamcinolone, beclomethasone, flunisolide, fluticasone, budesonide, ciclesonideNROther medications, overall comorbidity, cumulative dose
Lee et al. 2018 [46]KoreaCase-control
2002-2013
68265t
1060c
Triamcinolone, beclomethasone, flunisolide, fluticasone, budesonide, ciclesonide1Smoking intensity, BMI, comorbidity, household income
Kiri et al. 2008 [47]UKCase-control
1989-2003
NRt
c
124t
1470c
ICSE
LABDC
NRUse of other respiratory medications, comorbidity including asthma, duration of smoking, time from smoking cessation
Liu et al. 2007 [48]TaiwanCohort
1997-2009
10.21290t
12396c
Fluticasone, budesonideNRAge, income, comorbidity
Pauwels et al. 1999 [49]9 European countriesRCTNRt
c
634t
643c
BudesonideNRUnreported confounders
Sorli et al. 2018 [50]NorwayCohort
1996-2008
NR61t
58c
1095t
1946c
Beclomethasone, fluticasone, budesonide6Sex, smoking pack-years
Sandelin et al. 2018 [51]SwedenCohort
1999-2009
NRt
c
594t
19300c
ICSNRAge at COPD diagnosis, gender, asthma, educational level, marital status, income prior to index, medication, comorbidities
Wu et al. 2016 [52]TaiwanCohort
2003-2010
NR65.0t
65.0c
8812t
35,252c
Beclomethasone, budesonide, fluticasone, and ciclesonideNRSex, age, medications, comorbidities, inpatient and outpatient visits for respiratory diseases, and urbanization
Lin et al. 2019 [53]TaiwanCohort
2000-2010
NR2,682t
2,682c
ICSNRGender, age, work occupation, and comorbidities
Husebo et al. 2019 [54]NorwayCohort
2009-2010
NR63.5t
63.5c
64t
58c
ICS9Age, sex, smoking status, pack-years smoked, and body composition

NR: not reported. tICS-treated group. cControl (non-ICS group). RCT: randomized controlled trial; CVD: cardiovascular disease; BMI: body mass index; DM: diabetes mellitus; COPD: chronic obstructive pulmonary disease; ICS: inhaled corticosteroid; SD: standard deviation.