Association between tuberculosis infections and non-pulmonary malignancies: a nationwide population-based study

• Published in: British journal of cancer Vol. 109; no. 1; pp. 229 - 234
• Main Authors: Kuo, S-C, Hu, Y-W, Liu, C-J, Lee, Y-T, Chen, Y-T, Chen, T-L, Chen, T-J, Fung, C-P
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 09-07-2013; Nature Publishing Group
• Subjects: 692/499; 692/699/255/1856; 692/699/67; Adult; Aged; Bacterial diseases; Bacterial diseases of the respiratory system; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cancer Research; Cohort Studies; Drug Resistance; Epidemiology; Esophagus; Female; Gender; Hospitals; Human bacterial diseases; Humans; Illnesses; Incidence; Infections; Infectious diseases; Leukemia; Lung cancer; Male; Medical research; Medical sciences; Medicine; Middle Aged; Molecular Medicine; Mortality; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Mycobacterium; National health insurance; Neoplasms - epidemiology; Oncology; Population-based studies; Public health; Registries; Risk Factors; Sex Factors; Taiwan - epidemiology; Tuberculosis; Tuberculosis - epidemiology; Tumors; Young Adult; Taiwan; tuberculosis infections; standardized incidence ratios; Human; Lung disease; Respiratory disease; Pulmonary tuberculosis; Malignancy; Mycobacterial infection; Malignant tumor; Epidemiology; Incidence; Infection; Association; Cancerology; Bacteriosis; Cancer
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.2013.220

Background:
In addition to lung cancers, tuberculosis infections have been associated with increased risk of non-pulmonary malignancies in case reports. Our population-based study employed standardized incidence ratios (SIRs) to systemically survey non-pulmonary cancer risks after tuberculosis infections.
Methods:
Data of patients who had newly diagnosed tuberculosis, were aged 20 years or older, and had no prior cancer or tuberculosis were sampled from the Taiwan National Health Insurance database between 2000 and 2010. SIRs compared cancer incidence in patients with tuberculosis infections to the general population. SIRs of specific cancers were further analyzed with respect to gender and time after tuberculosis infections.
Results:
After a follow-up period of 28 866 person–years, 530 tuberculosis cases developed cancers compared with 256 cases in the general populations (2.07, 95% confidence interval (CI), 1.90–2.26). The SIR of non-pulmonary malignancies was also increased (1.71, 95% CI, 1.54–1.90). For males, SIRs were increased within 1 year after tuberculosis diagnosis for the following cancers: head and neck, esophageal, colorectal, liver, lung, melanomas, and Hodgkin’s disease. SIRs were increased for liver, biliary, lung, and bladder cancers beyond the first year after tuberculosis diagnosis. For females, SIRs were increased for leukemia, esophageal, and lung cancers within the first year, and only for leukemia beyond 1 year post diagnosis.
Conclusion:
Having found increased risks of several cancers that differ with gender and time after tuberculosis diagnosis, physicians may consider these factors in patients following tuberculosis diagnosis.