TY - JOUR
T1 - Risk of Malignancy in Patients with Asthma‐COPD Overlap Compared to Patients with COPD without Asthma
AU - Bonnesen, Barbara
AU - Sivapalan, Pradeesh
AU - Jordan, Alexander
AU - Pedersen, Johannes Wirenfeldt
AU - Bergsøe, Christina Marisa
AU - Eklöf, Josefin
AU - Toennesen, Louise Lindhardt
AU - Jensen, Sidse Graff
AU - Naqibullah, Matiullah
AU - Saghir, Zaigham
AU - Jensen, Jens Ulrik Stæhr
N1 - Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.
PY - 2022
Y1 - 2022
N2 - Chronic inflammation such as asthma may lead to higher risks of malignancy, which may be inhibited by anti‐inflammatory medicine such as inhaled corticosteroids (ICS). The aim of this study was to evaluate if patients with asthma‐Chronic Obstructive Pulmonary Disease (COPD) overlap have a higher risk of malignancy than patients with COPD without asthma, and, secondarily, if inhaled corticosteroids modify such a risk in a nationwide multi‐center retrospective cohort study of Danish COPD‐outpatients with or without asthma. Patients with asthma‐COPD overlap were propensity score matched (PSM) 1:2 to patients with COPD without asthma. The endpoint was cancer diagnosis within 2 years. Patients were stratified depending on prior malignancy within 5 years. ICS was explored as a possible risk modifier. We included 50,897 outpatients with COPD; 88% without prior malignancy and 20% with asthma. In the PSM cohorts, 26,003 patients without prior malignancy and 3331 patients with prior malignancy were analyzed. There was no association between asthma‐COPD overlap and cancer with hazard ratio (HR) = 0.92, CI = 0.78–1.08, p = 0.31 (no prior malignancy) and HR = 1.04, CI = 0.85–1.26, and p = 0.74 (prior malignancy) as compared to patients with COPD without asthma. ICS did not seem to modify the risk of cancer. In conclusion, in our study, asthma‐COPD overlap was not associated with an increased risk of cancer events.
AB - Chronic inflammation such as asthma may lead to higher risks of malignancy, which may be inhibited by anti‐inflammatory medicine such as inhaled corticosteroids (ICS). The aim of this study was to evaluate if patients with asthma‐Chronic Obstructive Pulmonary Disease (COPD) overlap have a higher risk of malignancy than patients with COPD without asthma, and, secondarily, if inhaled corticosteroids modify such a risk in a nationwide multi‐center retrospective cohort study of Danish COPD‐outpatients with or without asthma. Patients with asthma‐COPD overlap were propensity score matched (PSM) 1:2 to patients with COPD without asthma. The endpoint was cancer diagnosis within 2 years. Patients were stratified depending on prior malignancy within 5 years. ICS was explored as a possible risk modifier. We included 50,897 outpatients with COPD; 88% without prior malignancy and 20% with asthma. In the PSM cohorts, 26,003 patients without prior malignancy and 3331 patients with prior malignancy were analyzed. There was no association between asthma‐COPD overlap and cancer with hazard ratio (HR) = 0.92, CI = 0.78–1.08, p = 0.31 (no prior malignancy) and HR = 1.04, CI = 0.85–1.26, and p = 0.74 (prior malignancy) as compared to patients with COPD without asthma. ICS did not seem to modify the risk of cancer. In conclusion, in our study, asthma‐COPD overlap was not associated with an increased risk of cancer events.
KW - asthma
KW - asthma‐COPD overlap
KW - cancer
KW - Chronic Obstructive Pulmonary Disease
KW - COPD
KW - ICS
KW - inhaled corticosteroids
U2 - 10.3390/biomedicines10071463
DO - 10.3390/biomedicines10071463
M3 - Journal article
C2 - 35884768
AN - SCOPUS:85133159800
SN - 2227-9059
VL - 10
JO - Biomedicines
JF - Biomedicines
IS - 7
M1 - 1463
ER -