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01.12.2015 | Research article | Ausgabe 1/2015 Open Access

BMC Pulmonary Medicine 1/2015

The use of corticosteroids in patients with COPD or asthma does not decrease lung squamous cell carcinoma

BMC Pulmonary Medicine > Ausgabe 1/2015
Zhi-Hong Jian, Jing-Yang Huang, Frank Cheau-Feng Lin, Oswald Ndi Nfor, Kai-Ming Jhang, Wen-Yuan Ku, Chien-Chang Ho, Chia-Chi Lung, Hui-Hsien Pan, Yu-Chiu Liang, Ming-Fang Wu, Yung-Po Liaw
Wichtige Hinweise
Zhi-Hong Jian and Jing-Yang Huang contributed equally to this work.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

ZHJ, YPL, and MFW conceived and designed the study. JYH, CCH, and CCL performed the experiments. ZHJ, JYH, CCH, and HHP analyzed the data. JYH and CCL contributed analysis tools. ONN, FCFL, WYK, KMJ, and YCL provided critical inputs on design, analysis, and interpretation of the study. ZHJ and JYH drafted the initial manuscript. All the authors had access to the data. All authors read and approved the final manuscript as submitted.



Asthma and COPD (chronic obstructive pulmonary disease) lead to persistent airway inflammation and are associated with lung cancer. The objective of the study was to assess the relationship between inhaled (ICS) and oral corticosteroid (OCS) use, and risk of lung squamous cell carcinoma (SqCC).


This study was a nested case–control study. Patients with newly diagnosed asthma or COPD between 2003 and 2010 were identified from the National Health Insurance Database. Cases were defined as patients diagnosed with SqCC after enrollment. For each case, four control individuals who were randomly matched for sex and age and date diagnosis of asthma or COPD were selected.


From the 1,672,455 eligible participants, 793 patients with SqCC were matched with 3,172 controls. The odds ratios (ORs) of SqCC in men who received high and low-dose ICS were 2.18 (95 %CI, 1.56–3.04) and 1.77 (1.22–2.57), respectively. Similarly, the ORs were 1.46 (95 %CI, 1.16–1.84) and 1.55 (95 %CI, 1.22–1.98) for men who were placed on low and high dose OCS. However, there was no significant association between cumulative ICS and/or OCS and risk of SqCC in women. Recent dose increase in corticosteriod was significantly associated with risk of SqCC. Specifically, among men, the ORs for SqCC were 8.08 (95 %CI, 3.22–20.30) for high-dose ICS + OCS, 4.49 (95 % CI, 2.05–9.85) for high-dose ICS, and 3.54 (95 % CI, 2.50–5.01) for high-dose OCS treatments, respectively. The OR for SqCC in women who received high-dose OCS was 6.72 (95 %CI, 2.69–16.81).


Corticosteroid use did not decrease SqCC in patients with asthma or COPD. Recent dose increase in corticosteroids was associated with SqCC.
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