Systemic glucocorticoids and the risk of breast cancer in a large nationwide case–control study

Abstract Background Concerns have been raised that long-term use of glucocorticoids may increase the risk of breast cancer, yet evidence is limited. Thus, this study investigated the association between systemic glucocorticoid use and breast cancer risk, overall and by breast cancer subtype and stag...

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Main Authors: Manon Cairat, Morten Olesen, Elea Olivier, Anton Pottegård, Blánaid Hicks
Format: Article
Language:English
Published: BMC 2025-06-01
Series:Breast Cancer Research
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Online Access:https://doi.org/10.1186/s13058-025-02071-0
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author Manon Cairat
Morten Olesen
Elea Olivier
Anton Pottegård
Blánaid Hicks
author_facet Manon Cairat
Morten Olesen
Elea Olivier
Anton Pottegård
Blánaid Hicks
author_sort Manon Cairat
collection DOAJ
description Abstract Background Concerns have been raised that long-term use of glucocorticoids may increase the risk of breast cancer, yet evidence is limited. Thus, this study investigated the association between systemic glucocorticoid use and breast cancer risk, overall and by breast cancer subtype and stage. Methods A nationwide case–control study was conducted using the Danish healthcare registries. Women with invasive breast cancer between 2001 and 2018 (n = 67,829) were identified as cases. Each case was matched to 10 population controls on age and calendar time. Ever users of glucocorticoids were defined as women who filled at least 2 prescriptions and long-term users those who filled prescriptions equivalent to ≥ 1000 defined daily doses (DDDs). Conditional logistic regressions were performed to calculate odds ratios (ORs) and 95% confidence intervals for the associations between glucocorticoid use and breast cancer risk. Results Twelve percent of women (n = 87,277) had ever been exposed to glucocorticoids and fewer than 1% were long-term users (n = 5,574). No association was found between ever use of glucocorticoids and breast cancer risk [OR = 1.00 (0.98—1.03)], compared with never use. However, an inverse association was observed between long-term glucocorticoid use and breast cancer risk [OR = 0.87 (0.77—0.97)], with suggestion of a slight dose–response relationship [OR per 500 DDDs = 0.96 (0.94—0.99)]. The associations were consistent across different tumour subtypes, estrogen receptor status, or clinical stage at diagnosis. Conclusion The findings from this large nationwide study did not suggest a positive association between glucocorticoids and breast cancer risk.
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spelling doaj-art-356edbdc04244f958b677efa375e1a722025-08-20T03:31:42ZengBMCBreast Cancer Research1465-542X2025-06-0127111010.1186/s13058-025-02071-0Systemic glucocorticoids and the risk of breast cancer in a large nationwide case–control studyManon Cairat0Morten Olesen1Elea Olivier2Anton Pottegård3Blánaid Hicks4Paris-Saclay University, UVSQ, Inserm, Gustave Roussy, Exposome and Heredity Team, CESPClinical Pharmacology and Pharmacy, Department of Public Health, University of Southern DenmarkParis-Saclay University, UVSQ, Inserm, Gustave Roussy, Exposome and Heredity Team, CESPClinical Pharmacology and Pharmacy, Department of Public Health, University of Southern DenmarkClinical Pharmacology and Pharmacy, Department of Public Health, University of Southern DenmarkAbstract Background Concerns have been raised that long-term use of glucocorticoids may increase the risk of breast cancer, yet evidence is limited. Thus, this study investigated the association between systemic glucocorticoid use and breast cancer risk, overall and by breast cancer subtype and stage. Methods A nationwide case–control study was conducted using the Danish healthcare registries. Women with invasive breast cancer between 2001 and 2018 (n = 67,829) were identified as cases. Each case was matched to 10 population controls on age and calendar time. Ever users of glucocorticoids were defined as women who filled at least 2 prescriptions and long-term users those who filled prescriptions equivalent to ≥ 1000 defined daily doses (DDDs). Conditional logistic regressions were performed to calculate odds ratios (ORs) and 95% confidence intervals for the associations between glucocorticoid use and breast cancer risk. Results Twelve percent of women (n = 87,277) had ever been exposed to glucocorticoids and fewer than 1% were long-term users (n = 5,574). No association was found between ever use of glucocorticoids and breast cancer risk [OR = 1.00 (0.98—1.03)], compared with never use. However, an inverse association was observed between long-term glucocorticoid use and breast cancer risk [OR = 0.87 (0.77—0.97)], with suggestion of a slight dose–response relationship [OR per 500 DDDs = 0.96 (0.94—0.99)]. The associations were consistent across different tumour subtypes, estrogen receptor status, or clinical stage at diagnosis. Conclusion The findings from this large nationwide study did not suggest a positive association between glucocorticoids and breast cancer risk.https://doi.org/10.1186/s13058-025-02071-0GlucocortiocoidsBreast cancerRegistries
spellingShingle Manon Cairat
Morten Olesen
Elea Olivier
Anton Pottegård
Blánaid Hicks
Systemic glucocorticoids and the risk of breast cancer in a large nationwide case–control study
Breast Cancer Research
Glucocortiocoids
Breast cancer
Registries
title Systemic glucocorticoids and the risk of breast cancer in a large nationwide case–control study
title_full Systemic glucocorticoids and the risk of breast cancer in a large nationwide case–control study
title_fullStr Systemic glucocorticoids and the risk of breast cancer in a large nationwide case–control study
title_full_unstemmed Systemic glucocorticoids and the risk of breast cancer in a large nationwide case–control study
title_short Systemic glucocorticoids and the risk of breast cancer in a large nationwide case–control study
title_sort systemic glucocorticoids and the risk of breast cancer in a large nationwide case control study
topic Glucocortiocoids
Breast cancer
Registries
url https://doi.org/10.1186/s13058-025-02071-0
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AT eleaolivier systemicglucocorticoidsandtheriskofbreastcancerinalargenationwidecasecontrolstudy
AT antonpottegard systemicglucocorticoidsandtheriskofbreastcancerinalargenationwidecasecontrolstudy
AT blanaidhicks systemicglucocorticoidsandtheriskofbreastcancerinalargenationwidecasecontrolstudy