title: Post-Inhaled Corticosteroid Pulmonary Tuberculosis Increases Lung Cancer in Patients with Asthma.
abstract: OBJECTIVE
  To evaluate the association between post-inhaled corticosteroid (ICS) pulmonary tuberculosis (TB), pneumonia and lung cancer in patients with asthma.
  
  
  METHODS
  The study samples were collected from the National Health Insurance Database. Asthmatic patients who were first-time users of ICS between 2003 and 2005 were identified as cases. For each case, 4 control individuals were randomly matched for sex, age and date of ICS use. Cases and matched controls were followed up until the end of 2010. Cox proportional hazard regression was used to determine the hazard ratio for pulmonary infections and lung cancer risk in the ICS users and non-users.
  
  
  RESULTS
  A total of 10,904 first-time users of ICS were matched with 43,616 controls. The hazard ratios for lung cancer were: 2.52 (95% confidence interval [CI], 1.22-5.22; p = 0.012) for individuals with post-ICS TB, 1.28 (95%CI, 0.73-2.26; p = 0.389) for post-ICS pneumonia, 2.31(95%CI, 0.84-6.38; p = 0.105) for post-ICS pneumonia+TB, 1.08 (95%CI, 0.57-2.03; p = 0.815) for TB, 0.99 (95%CI, 0.63-1.55; p = 0.970) for pneumonia, and 0.32 (95%CI, 0.05-2.32; p = 0.261) for pneumonia+ TB, respectively.
  
  
  CONCLUSIONS
  Post-ICS TB increased lung cancer risk in patients with asthma. Because of the high mortality associated with lung cancer, screening tests are recommended for patients with post-ICS TB.
authors.affiliation: Department of Public Health and Institute of Public Health, Chung Shan Medical University, Taichung City, Taiwan.
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 City, Taiwan.
authors.forename: Jing-Yang
authors.initials: JY
authors.lastname: Huang
authors.affiliation: School of Medicine, Chung Shan Medical University, Taichung City, Taiwan.|Department of Thoracic Surgery, Chung Shan Medical University Hospital, Taichung City, Taiwan.
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 City, Taiwan.
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 City, Taiwan.|Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan.
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 City, Taiwan.
authors.forename: Wen-Yuan
authors.initials: WY
authors.lastname: Ku
authors.affiliation: Department of Physical Education, Fu Jen Catholic University, New Taipei City, Taiwan.
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 City, Taiwan.|Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan.
authors.forename: Chia-Chi
authors.initials: CC
authors.lastname: Lung
authors.affiliation: School of Medicine, Chung Shan Medical University, Taichung City, Taiwan.|Department of Pediatrics, Chung Shan Medical University Hospital, Taichung City, Taiwan.
authors.forename: Hui-Hsien
authors.initials: HH
authors.lastname: Pan
authors.affiliation: Office of Physical Education, Chung Yuan Christian University, Taoyuan City, Taiwan.
authors.forename: Min-Chen
authors.initials: MC
authors.lastname: Wu
authors.affiliation: School of Medicine, Chung Shan Medical University, Taichung City, Taiwan.|Divisions of Medical Oncology and Pulmonary Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan.
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 City, Taiwan.|Department of Family and Community Medicine, Chung Shan Medical University Hospital, Taichung City, Taiwan.
authors.forename: Yung-Po
authors.initials: YP
authors.lastname: Liaw
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001249:Asthma / Q000150:complications* / Q000188:drug therapy; D015897:Comorbidity; D016208:Databases, Factual; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000453:epidemiology* / Q000209:etiology* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000150:complications / Q000209:etiology; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D013624:Taiwan / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000209:etiology; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones