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Free Content Aerodigestive tract, lung and haematological cancers are risk factors for tuberculosis: an 8-year population-based study

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SETTING: The deterioration of immunity in cancer patients may be associated with a higher incidence of tuberculosis (TB).

OBJECTIVE: Despite several previous studies on cancer and TB, no population-based investigation has been published. We performed a nationwide population-based study to investigate the incidence of active TB among cancer patients, and the cancer-type specific risk factors related to TB.

DESIGNS: This nationwide population-based retrospective cohort study was based on data obtained from the Taiwan National Health Insurance Database. A total of 16 487 cancer patients and 65 948 controls matched for age and sex were recruited.

RESULTS: The incidence of TB per 100 000 person-years was 339 in the cancer patients and 202 in the controls, which gives a crude incidence rate ratio of 1.68 (95%CI 1.42–1.98). The hazard ratio (HR) was 1.67 (95%CI 1.42–1.96) after adjusting for age, sex and comorbidity. Cox regression showed that cancers of the aerodigestive tract, including oral, nasopharyngeal and oesophageal and lung cancer (HR 3.09, 95%CI 2.42–3.94) and haematological cancers, including non-Hodgkin's lymphoma and leukaemia (HR 3.22, 95%CI 1.98–5.22), were significant risk factors for TB.

CONCLUSION: Cancer patients have a higher incidence of TB than controls. Patients with aerodigestive tract, lung and haematological cancers are especially vulnerable to TB.

Keywords: aerodigestive tract; cancer; haematological; lung; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Institute of Public Health, National Yang-Ming University, Taipei, Taiwan; Division of Dermatology, Taipei County Hospital, Taipei, Taiwan 2: Department of Senior Citizen Service Management, Ching-Kuo Institute of Management and Health, Keelung, Taiwan 3: Institute of Public Health, National Yang-Ming University, Taipei, Taiwan 4: Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan 5: Division of Surgery, Taipei County Hospital, Taipei, Taiwan 6: Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; National Yang-Ming University School of Medicine, Taipei, Taiwan

Publication date: 2011-01-01

More about this publication?
  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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