Suissa S, et al. - Researchers examined the link between the use of inhaled corticosteroids (ICS) and the incidence of lung cancer in COPD, employing an approach that avoided biases influencing some of the studies. They used the Quebec healthcare databases to form a cohort of patients with COPD, new users of long-acting bronchodilators over 2000–2014, observed until 2015 for a first diagnosis of lung cancer. Overall 58,177 people were examined, including 63% taking ICS. A mean follow-up of 5 years revealed the occurrence of 954 lung cancers. The adjusted hazard ratio of lung cancer related to any ICS exposure was 0.94, vs no ICS use. Findings revealed no link of ICS use with a decrease in lung cancer incidence in patients with COPD. Time-associated biases and the incorporation of patients with asthma may have influenced observational studies showing such decrease. The proposition of a randomised trial warrants some caution.