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High Dose Inhaled Corticosteroid Use for COPD Could Cut Risk of Lung Cancer

Among a group of mostly older male veterans suffering from chronic obstructive pulmonary disease (COPD), an illness that offers a greater// susceptibility to lung cancer, researchers found that regular use of high dose inhaled corticosteroids (ICS) lowered the risk of developing lung cancer.

David H. Au, M.D., M.S., of the Veterans Administration Puget Sound Health Care System in Seattle, along with five associates found that among 10,474 patients with COPD, 517 were considered regular users of ICS.

Among users of more than 1,200 micrograms of ICS per day, the relative risk for lung cancer was lowered to 0.39. For users of less than 1,200 micrograms per day, the relative risk was 1.13. (A relative risk of 1 means there is no difference in risk between two groups.)

Over the next four years, the researchers found that among a total of 9,957 nonusers of ICS, 402 developed lung cancer. For 298 users of ICS at a level below 1,200 micrograms per day, 16 developed lung cancer. Among 219 patients who used over 1,200 micrograms per day, five developed lung cancer.

“Lung cancer is the most common cause of cancer-related death in the United States and accounts for more deaths each year than breast, prostate and colon-rectal cancer combined,” said Dr. Au. “Studies such as the Lung Health Study have demonstrated that the most common cause of death among subjects with COPD is lung cancer.”

In 2004, more than 11 million U.S. adults were estimated to suffer from COPD, which results from chronic bronchitis and emphysema, two inflammatory lung diseases that frequently co-exist and interfere with normal breathing. Smoking is the primary cause of COPD.

“Tobacco smoke is a well-recognized stimulant of systemic and local inflammation and the role of inflammation in the causal pathway for both lung cancer and COPD has been suggested,” said Dr. Au.

The researchers noted that ICS have been shown in prospectiv
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