Risk Factors for Pulmonary Tuberculosis in Patients with Lung Cancer: A Retrospective Cohort Study

Kuang-Ming Liao; Chin-Chung Shu; Fu-Wen Liang; Yi-Chen Chen; Chia-Hung Yu; Jhi-Joung Wang; Chung-Han Ho

doi:10.7150/jca.81616

Risk Factors for Pulmonary Tuberculosis in Patients with Lung Cancer: A Retrospective Cohort Study

J Cancer. 2023 Mar 5;14(4):657-664. doi: 10.7150/jca.81616. eCollection 2023.

Authors

Kuang-Ming Liao¹, Chin-Chung Shu^{2

3}, Fu-Wen Liang^{4

5}, Yi-Chen Chen⁶, Chia-Hung Yu⁷, Jhi-Joung Wang^{6

7}, Chung-Han Ho^{6

8

9}

Affiliations

¹ Department of Internal Medicine, Chi Mei Medical Center, Chiali. Tainan, Taiwan.
² Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
³ College of Medicine, National Taiwan University, Taipei, Taiwan.
⁴ Department of Public Health, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan.
⁵ Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
⁶ Department of Medical Research, Chi Mei Medical Center. Tainan, Taiwan.
⁷ Department of Anaesthesiology, Chi Mei Medical Center, Tainan, Taiwan.
⁸ Cancer Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
⁹ Department of Information Management, Southern Taiwan University of Science and Technology, Tainan, Taiwan.

Abstract

Background: Lung cancer increases the risk for pulmonary tuberculosis (PTB). The risk factors for newly diagnosed PTB are not known in lung cancer. This study analyzed risk factors of new-onset PTB among lung cancer patients in Taiwan. Methods: Taiwan's National Health Insurance Research Database and Taiwan Cancer Registry were used to define PTB and lung cancer patients between 2007 and 2015. Considering that mortality was a competing risk event during the cancer treatment, Fine and Gray method was performed to estimate the possible risk factors for PTB among lung cancer patients. Results: A total of 1,335 patients had PTB after lung cancer. The incidence of PTB increased with patients' raising age. Males had 1.7-fold (95% CI: 1.5-2.0) risk of PTB compared with females. Patients aged between 60-69 years (HR: 1.4; 95% CI: 1.1-1.8) and those ≥70 years (HR: 1.9; 95% CI: 1.5-2.4) had higher PTB risk than those aged under 50 years. Patients with history of pneumoconiosis and patients who received the treatments of surgery and chemotherapy also had significant increasing risk of PTB. Conclusion: Screening for PTB may be important among lung cancer patients with the aforementioned risk factors.

Keywords: Taiwan Cancer Registry; lung cancer; population database; risk factor; tuberculosis.