Inhaled Steroids May Lower Risk of Lung Cancer in People With COPD

Recently I posted about the increased risk of lung cancer in people who have COPD. It seems that once you have COPD, you are 4 to 5 times as likely to develop lung cancer down the line.1,2 This risk prompted researchers to look for answers. Now, a new study suggests that taking inhaled steroids may lower the risk of lung cancer in people with COPD.3

Inhaled steroids and COPD

COPD is an inflammatory disease of the airways.4 Doctors commonly use anti-inflammatory medications such as inhaled steroids in the treatment of asthma, another inflammatory airway disease. However, the use of inhaled steroids for COPD is more controversial.5 In fact, steroids are generally only used in COPD patients in these cases:5

  • When there is a high risk of COPD exacerbations
  • If the patient as both COPD and asthma

And even in these cases, doctors tend to use inhaled steroids in conjunction with the more commonly-prescribed long-acting bronchodilators.5 Within the scientific community, there is not complete consensus on the benefits of using inhaled steroids as a treatment for COPD. Some experts question whether there is a subgroup of patients with COPD that might respond better to inhaled steroids, but this remains to be proven.5

This new study may provide another reason for using inhaled steroids in COPD patients in order to lower lung cancer risk.

Details of the study

The study was published in the April 7, 2019 issue of the European Respiratory Journal.1 It reported on work done by researchers at the University of British Columbia in Canada. This was a type of study called a retrospective study, where researchers observe past data using certain factors for evaluation. According to statsdirect.com: "A retrospective study looks backwards and examines exposures to suspected risk or protection factors in relation to an outcome that is established at the start of the study." This is different from the kind of study where the outcome is unknown at the start and researchers may apply some sort of intervention to see what happens.

Here are more details of this study:

  • The team analyzed 10 years of medical and pharmacy data for 39,676 people in British Columbia who had COPD
  • Patients all aged over 50 years; mean age was 70.7 years
  • All patients had been prescribed at least 3 medications for COPD
  • 2.5% (994) of the study group of 39,676 had contracted lung cancer

Researchers then compared whether those who did not contract lung cancer vs. those who did had been on inhaled steroids.

Inhaled steroids appeared to lower the risk of lung cancer

After examining all the data, the researchers at the University of British Columbia concluded that taking inhaled steroids appeared to lower the risk of getting lung cancer after having COPD.5 In fact, in a press release, Larry Lynd, PhD, one of the co-authors of the study, says: "Results showed that if you had COPD and consistently used a steroid inhaler, your chances of getting lung cancer were between 25 percent and 30 percent lower, compared to people who took other treatments.”

However, the researchers also pointed out that there were some limitations to their study:6

  • The data suggests a link, but not an exact cause and effect relationship.
  • There is no proof that using inhaled steroids prevents lung cancer altogether.
  • The data relied on administrative record keeping, which was somewhat limited in scope.

In the future, the study team hopes to take a closer look at how inhaled steroids might help to reduce the risk of lung cancer in people with COPD.

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