5MinuteConsult Journal Club

Asthma Increases Cancer Risk

Reference

Guo, Y, Bian, J, Chen, Z, et al. Cancer incidence after asthma diagnosis: Evidence from a large clinical research network in the United States. Cancer Med. 2023; 00: 1- 7. doi:10.1002/cam4.5875

Study Summary

This was a retrospective analysis of over 90,000 patients with asthma versus 270,000 without asthma to determine if there was a correlation between asthma and the development of some cancers over < 15 months. Most patients in both groups were women (69.5% and 70.8% respectively) and white (50.3% and 44.5%). Asthma patients had a statistically higher rate of smokers, stroke, hypertension, and diabetes.

They found a higher percentage of asthma patients diagnosed with cancer than non-asthma patients (2.9% vs. 1.8%; p < 0.001). After multivariable analysis, the hazard ratio for developing a cancer was increased by over 30% ([HR] = 1.36, 99% [CI] = 1.29–1.44).

Interestingly, there was a greater cancer risk in asthma patients without steroid inhaler use (HR = 1.60; 99% CI: 1.50–1.71) vs. those with a regular inhaled steroid use (HR = 1.11; 99% CI: 1.03–1.21).

They found in those with asthma but not on a steroid inhaler an increased risk of the following cancers: prostate, lung, CRC, blood cancers, uterine, melanoma, renal, ovarian and cervical. But for those with asthma on a steroid inhaler, only lung and melanoma risk was increased, but the inhaled steroid group had a LOWERED risk of uterine cancer (by 50%!).

Conclusions

Asthma may increase the risk of some cancers. Some of this risk may be reduced by being on an inhaled steroid.

Putting someone on an inhaled steroid just to prevent cancer seems premature. But, considering the new GINA guidelines on the management of asthma, most children, adolescents, and adults should be using a steroid inhaler daily unless their symptoms are mild and rare. Seems like a win-win.

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