Table 2 Use of glucocorticoids and risk of skin cancer and non-Hodgkin's lymphoma

	All prescriptions before diagnosis date					Prescriptions>1 year before diagnosis date	Prescriptions>5 years before diagnosis date
	Cases N (%)	Controls N (%)	IRR age and gender adjusted (95% CI)	IRR adjusted ^a (95% CI)	P -value for trend test (adjusted)	IRR adjusted ^a (95% CI)	IRR adjusted ^a (95% CI)
Basal cell carcinoma
No prescriptions	4300 (79%)	18278 (81%)	1.00	1.00	—	1.00	1.00
Any prescription	1122 (21%)	4179 (19%)	1.17 (1.08–1.27)	1.15 (1.07–1.25)		1.17 (1.08–1.28)	1.22 (1.09–1.36)
Risk increase per 10 000 mg^b			1.10 (0.98–1.22)	1.07 (0.96–1.20)	0.2
Squamous cell carcinoma
No prescriptions	732 (78%)	3379 (81%)	1.00	1.00	—	1.00	1.00
Any prescription	203 (22%)	787 (19%)	1.21 (1.01–1.46)	1.14 (0.94–1.39)		1.09 (0.88–1.34)	1.11 (0.85–1.45)
Risk increase per 10 000 mg^b			1.23 (0.98–1.54)	1.12 (0.88–1.43)^c	0.4
Malignant melanoma
No prescriptions	820 (83%)	3696 (84%)	1.00	1.00	—	1.00	1.00
Any prescription	163 (17%)	710 (16%)	1.09 (0.90–1.33)	1.15 (0.94–1.41)		1.12 (0.90–1.39)	1.00 (0.75–1.36)
Risk increase per 10 000 mg^b			1.11 (0.91–1.37)	0.94 (0.65–1.37)	0.8
Non-Hodgkin's lymphoma
No prescriptions	383 (80%)	1648 (82%)	1.00	1.00	—	1.00	1.00
Any prescription	98 (20%)	356 (18%)	1.20 (0.92–1.56)	1.11 (0.85–1.46)		1.08 (0.81–1.44)	1.04 (0.71–1.54)
Risk increase per 10 000 mg^b			2.51 (1.41–4.49)	2.26 (1.20–4.26)	0.01

CI=confidence interval; IRR=incidence rate ratio; SCC=squamous cell carcinoma.
^aConditional logistic regression was used to estimate IRRs and 95% CI, adjustments were made for a prior hospitalisation for selected chronic diseases and use of methotrexate and azathioprine.
^bIn this model we assumed a linear effect of the exposure.
^cThe restricted cubic spline showed the best fit to the data (Harre et al, 1988), with a statistically significant increased risk of SCC with increasing amounts of glucocorticoids prescribed (cumulative IRR per 10 000 mg=7.40 (95% CI: 1.80–30.4), P=0.001).

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