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Review
. 2022 Jan 30;11(3):765.
doi: 10.3390/jcm11030765.

Pulmonary Tuberculosis and Risk of Lung Cancer: A Systematic Review and Meta-Analysis

Soo Young Hwang  1 , Jong Yeob Kim  1 , Hye Sun Lee  2 , Sujee Lee  2 , Dayeong Kim  3 , Subin Kim  3 , Jong Hoon Hyun  3 , Jae Il Shin  4 , Kyoung Hwa Lee  3 , Sang Hoon Han  3 , Young Goo Song  3
Affiliations
Review

Pulmonary Tuberculosis and Risk of Lung Cancer: A Systematic Review and Meta-Analysis

Soo Young Hwang et al. J Clin Med. .

Abstract

Pulmonary tuberculosis (TB) is a known risk factor for lung cancer. However, a detailed analysis of lung cancer type, age, sex, smoking, and TB burden associated with geographic and socioeconomic status has not been performed previously. We systematically appraised relevant observational studies reporting an association between pulmonary TB and lung cancer. All studies were included in the primary analysis, and studies that used robust TB diagnostic methods, such as validated medical diagnostic codes, were included in the secondary analysis. Thirty-two articles were included. The association between the history of pulmonary TB and diagnosis of lung cancer was statistically significant (OR 2.09, 95% CI: 1.62-2.69, p < 0.001). There was a high heterogeneity (I2 = 95%), without any publication bias. The analysis indicated a high association in advanced articles describing stringent pulmonary TB diagnosis (OR 2.26, 95% CI: 1.29-3.94, p = 0.004). The subgroup analyses suggested a significant association in countries with medium or high TB burdens, from East Asia and the Pacific region, and upper-middle income countries. Heterogeneity within the subgroups remained high in a majority of the subgroup analyses. A meta-regression analysis revealed that younger patients showed a significantly higher association between TB and lung cancer (regression coefficient = 0.949, p < 0.001). The history of pulmonary TB is an independent risk factor for lung cancer, especially in younger patients diagnosed with pulmonary TB. Clinicians should be aware of this association while treating young patients with a history of pulmonary TB.

Keywords: burden of tuberculosis; lung cancer; meta regression; pulmonary tuberculosis.

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Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Figure 1
Figure 1
Flow chart of the included studies.
Figure 2
Figure 2
Forest plots of risk estimates for the association between tuberculosis and lung cancer. (A) Meta-analysis of all eligible studies. (B) Meta-analysis of high-quality studies.
Figure 2
Figure 2
Forest plots of risk estimates for the association between tuberculosis and lung cancer. (A) Meta-analysis of all eligible studies. (B) Meta-analysis of high-quality studies.
Figure 3
Figure 3
Funnel plot of the study estimates. (A) All eligible studies. (B) High-quality studies.
Figure 4
Figure 4
Meta-regression analysis of the mean patient age and association between tuberculosis and lung cancer. (A) All eligible studies. (B) High-quality studies.
Figure 4
Figure 4
Meta-regression analysis of the mean patient age and association between tuberculosis and lung cancer. (A) All eligible studies. (B) High-quality studies.
See this image and copyright information in PMC

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