The risk of certain types of cancer may be higher in patients currently or previously diagnosed with tuberculosis, according to new findings to be presented by Kim et al at the upcoming 2024 European Congress of Clinical Microbiology and Infectious Diseases (ECCMID) annual congress.
Background
Although tuberculosis can be successfully cured, the disease can cause structural or vascular damage, metabolic abnormalities, and host inflammatory response that may lead to complications such as an increased risk of cancer. This increased risk may be influenced by host tissue and DNA damage as well as interruption of normal gene repair processes and growth factors present in the blood.
Study Methods and Results
In the new population-wide observational study, investigators used data from the 2010 to 2017 National Health Insurance Service–National Health Information Database of South Korea to examine the incidence of newly diagnosed cancer among 72,542 patients with a mean age of 62 years and tuberculosis and 72,542 controls randomly selected from the general population in a 1:5 ratio and matched on the basis of sex, age, income level, residence, and index year. The patients with tuberculosis were defined as those with a disease code for tuberculosis entered into the system or treated with two or more tuberculosis drugs for over 28 days. The primary outcome of the study was cancer incidence in patients diagnosed with tuberculosis infections between 2010 and 2017 compared with the matched cohort. The secondary outcomes were to investigate the risk factors for cancer incidence in patients with tuberculosis.
After a mean follow-up duration of 67 months, the investigators found that the incidence of all cancer types combined, colorectal cancer, thyroid cancer, and esophageal and gastric cancers was a respective 80%, 57%, 56%, and 55% higher among the patients with tuberculosis compared with controls. Further, the patients in the tuberculosis group had 3.6 times the incidence of lung cancer, 2.4 times the incidence of hematologic malignancies, and 2.2 times the incidence of gynecologic cancer.
After adjustment, current smoking (40% increased risk vs nonsmokers), heavy alcohol consumption (15% increased risk vs regular alcohol consumption), chronic liver disease (42% increased risk vs no liver disease), and chronic obstructive pulmonary disease (8% increased risk) were identified as independent risk factors for the incidence of cancer in patients with tuberculosis.
Conclusions
“[Tuberculosis] is an independent risk factor for cancer, not only lung cancer, but also various site-specific cancers, after adjusting for confounders. Screening and management for cancer should be warranted in patients with [tuberculosis],” the study authors concluded.
