Asthma-COPD Not Associated With Increased Cancer Risk

Patients with asthma and chronic obstructive pulmonary disease (COPD) do not have an increased risk of developing cancer compared with patients with COPD, according to a recent study.

Barbara Bonnesen, MD, MS, of the Herlev and Gentofte Hospital at the University of Copenhagen, and colleagues conducted the study. The results were published in Biomedicines.

Investigators combined data from 4 Danish databases to conduct the multicenter, retrospective cohort study. The study included all Danish residents over 30 who were diagnosed with COPD between January 2010 and June 2017 (n=50 897).

Most patients (88%) had no prior malignancy in the 5 years before they entered the study. The proportions of patients with asthma-COPD overlap were similar between the patients who had no prior malignancy (19%) and patients who had a prior malignancy (18.3%).

Cancer risk in patients without prior malignancy

In patients without prior malignancy, the risk of cancer was not increased in patients who had asthma-COPD compared with patients who had COPD (hazard ratio [HR], 0.92; CI, 0.78-1.08; P=.31). The risk of lung cancer was also similar between patients without prior malignancy who had asthma-COPD and those who had COPD (HR, 0.77; CI, 0.56-1.07; P=.12).

The 2-year non-malignancy-caused mortality was similar among patients without prior malignancies, as researchers reported 1347 deaths in patients with asthma-COPD and 2786 deaths in patients with COPD (HR, 1.04; P=.31).

Cancer risk in patients with prior malignancy

In patients with prior malignancy, the risk of cancer was similar between those who had asthma-COPD and those who had COPD (HR, 1.04; CI, 0.85-1.26; P=.74). The risk of lung cancer in patients with prior malignancy was also similar between those with asthma-COPD and those with COPD (HR, 0.68; CI, 0.42-1.10; P=.11).

The 2-year non-malignancy-caused mortality was similar between groups with prior malignancy, as researchers reported 162 deaths in patients with asthma-COPD and 339 deaths in patients with COPD (HR, 0.89; P=.21).

Cancer risk and inhaled corticosteroid use

The risk of cancer was similar between patients who used low or medium doses of inhaled corticosteroids (ICS) in the year before study entry and patients who did not use ICS, the researchers reported.

However, patients on high-dose ICS had a “borderline lowered risk of all cancer events” (HR, 0.96; CI, 0.93-0.99; P=.01) and “a slightly higher mortality” from non-malignancy causes (HR, 1.03; CI, 1.02-1.04; P<.0001), according to investigators.

“Hence, our results suggest that neither a concomitant diagnosis of asthma nor use of [inhaled corticosteroids] should be considered independent risk or protective factors when assessing a patient with COPD and possible cancer,” the authors wrote. “As a consequence, our data do not support a different approach for cancer diagnostic workup or screening among patients with asthma-COPD-overlap as compared to patients with COPD without asthma.”

Bonnesen B, Sivapalan P, Jordan A, et al. Risk of malignancy in patients with asthma-COPD overlap compared to patients with COPD without asthma. Biomedicines. 2022;10(7):1463. doi:10.3390/biomedicines10071463