J Cancer 2020; 11(7):1899-1906. doi:10.7150/jca.37022 This issue

Research Paper

Pulmonary Tuberculosis is Associated with Elevated Risk of Lung cancer in Korea: The Nationwide Cohort Study

Chang-Mo Oh1*, Yun-Ho Roh2*, Dohee Lim3, Hyun-Joo Kong2, Hyunsoon Cho4, Bin Hwangbo5, Young-Joo Won2,4, Kyu-Won Jung2✉, Kyungwon Oh3✉

1. Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea.
2. Cancer Registration and Statistic Branch, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
3. Division of Health and Nutrition Survey, Centers for Disease Control and Prevention, Cheongju, Republic of Korea.
4. Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.
5. Center for lung Cancer, National Cancer Center, Goyang, Republic of Korea.
* The first two authors contributed equally to this study.

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Oh CM, Roh YH, Lim D, Kong HJ, Cho H, Hwangbo B, Won YJ, Jung KW, Oh K. Pulmonary Tuberculosis is Associated with Elevated Risk of Lung cancer in Korea: The Nationwide Cohort Study. J Cancer 2020; 11(7):1899-1906. doi:10.7150/jca.37022. Available from https://www.jcancer.org/v11p1899.htm

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Objective: Although previous studies suggest that previous pulmonary tuberculosis was associated with increased risk of lung cancer. It remains controversial whether pulmonary tuberculosis is a risk factor for lung cancer. Our study was aimed to examine the association between pulmonary tuberculosis and lung cancer risk in Korean.

Methods: The Korean National Health and Nutrition Examination Survey database was linked with the Korean National Cancer Incidence Database to examine the occurrence of pulmonary tuberculosis and lung cancer. The linked databases were also merged with causes of death database of Statistics Korea. The Cox-proportional hazards model was used to estimates the hazard risk of lung cancer for Korean adults aged ≥40 years with pulmonary tuberculosis.

Results: Of 20,252 total participants, 2,640 (13.0%) had old pulmonary tuberculosis (a medical history of pulmonary tuberculosis or radiologically inactive tuberculosis). After adjusting for all covariates, the hazard ratio of lung cancer among patients with old pulmonary tuberculosis was 3.24 (95% CI, 1.87‒5.62) compared to the control group. According to smoking status, the hazard ratios of lung cancer for never smokers, ex-smokers, and current smokers among participants with old pulmonary tuberculosis were 3.52 (95% CI, 1.17‒10.63), 2.16 (95% CI, 0.89‒5.24), and 3.71 (95% CI, 1.49‒9.22) compared to the control group, respectively.

Conclusions: Korean adults with old pulmonary tuberculosis have a higher risk of lung cancer, compared to general population without pulmonary tuberculosis.

Keywords: Lung neoplasms, tuberculosis, smoking, incidence