title: The use of corticosteroids in patients with COPD or asthma does not decrease lung squamous cell carcinoma.
abstract: BACKGROUND
  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).
  
  
  METHODS
  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.
  
  
  RESULTS
  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 corticosteroid 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).
  
  
  CONCLUSIONS
  Corticosteroid use did not decrease SqCC in patients with asthma or COPD. Recent dose increase in corticosteroids was associated with SqCC.
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan. s841039@yahoo.com.tw.
authors.forename: Zhi-Hong
authors.initials: ZH
authors.lastname: Jian
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan. wchinyang@yahoo.com.tw.
authors.forename: Jing-Yang
authors.initials: JY
authors.lastname: Huang
authors.affiliation: School of Medicine, Chung Shan Medical University, Taichung, Taiwan. frnklin@gmail.com.|Department of Thoracic Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan. frnklin@gmail.com.
authors.forename: Frank Cheau-Feng
authors.initials: FC
authors.lastname: Lin
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan. nforoswald2@yahoo.com.
authors.forename: Oswald Ndi
authors.initials: ON
authors.lastname: Nfor
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan. kmjhang@gmail.com.|Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan. kmjhang@gmail.com.
authors.forename: Kai-Ming
authors.initials: KM
authors.lastname: Jhang
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan. yuan3156@gmail.com.
authors.forename: Wen-Yuan
authors.initials: WY
authors.lastname: Ku
authors.affiliation: Department of Physical Education, Fu Jen Catholic University, New Taipei City, Taiwan. ccho1980@gmail.com.
authors.forename: Chien-Chang
authors.initials: CC
authors.lastname: Ho
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan. dinoljc@csmu.edu.tw.|Department of Family and Community Medicine, Chung Shan Medical University Hospital, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan. dinoljc@csmu.edu.tw.
authors.forename: Chia-Chi
authors.initials: CC
authors.lastname: Lung
authors.affiliation: School of Medicine, Chung Shan Medical University, Taichung, Taiwan. jsee06@yahoo.com.tw.|Department of Pediatrics, Chung Shan Medical University Hospital, Taichung, Taiwan. jsee06@yahoo.com.tw.
authors.forename: Hui-Hsien
authors.initials: HH
authors.lastname: Pan
authors.affiliation: College of Humanities and Social Sciences, Taipei Medical University, Taipei City, Taiwan. nicole0868@yahoo.com.tw.
authors.forename: Yu-Chiu
authors.initials: YC
authors.lastname: Liang
authors.affiliation: School of Medicine, Chung Shan Medical University, Taichung, Taiwan. mfwu0111@gmail.com.|Divisions of Medical Oncology and Pulmonary Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan. mfwu0111@gmail.com.
authors.forename: Ming-Fang
authors.initials: MF
authors.lastname: Wu
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung, Taiwan. liawyp@csmu.edu.tw.|Department of Family and Community Medicine, Chung Shan Medical University Hospital, No. 110, Sec. 1 Jianguo N. Rd., Taichung City, 40201, Taiwan. liawyp@csmu.edu.tw.
authors.forename: Yung-Po
authors.initials: YP
authors.lastname: Liaw
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000188:drug therapy*; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D065840:Protective Factors; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D012042:Registries; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000305:Adrenal Cortex Hormones