The Relationship Between Tuberculosis and Cancer: A Critical Review

The Relationship Between Tuberculosis and Cancer: A Critical Review

A recent population-wide observational study presented at the European Congress of Clinical Microbiology and Infectious Diseases (ECCMID 2024) in Barcelona, Spain, has shed light on the association between tuberculosis (TB) and cancer. The study revealed that individuals with current or previous TB are more likely to be diagnosed with various types of cancer, including lung, blood, gynecological, and colorectal cancers. Despite the possibility of successful cure of TB, complications can arise at different anatomical sites due to structural or vascular damage, metabolic abnormalities, and host inflammatory responses. These complications might increase the risk of cancer, which could be influenced by factors such as tissue and DNA damage, disruption of normal gene repair processes, and growth factors present in the blood.

Methodology

The study researchers retrospectively reviewed data from the National Health Insurance Service-National Health Information Database of South Korea from 2010 to 2017. Patients with TB were identified based on disease codes or treatment with two or more TB drugs for over 28 days. A control group from the general population was randomly selected in a 1:5 ratio and matched for sex, age, income level, residence, and index year. The analysis focused on the incidence of newly diagnosed cancer patients post-TB diagnosis, comparing the cancer rates in TB patients to those in the matched cohort.

Findings

The final analysis included a total of 72,542 patients with TB and an equal number of matched controls. The mean follow-up duration was 67 months, with TB patients averaging 62 years of age. The results indicated that TB patients had a significantly higher incidence of cancer compared to the general population. Specifically, the risk was 80% higher for all cancers combined, 3.6 times higher for lung cancer, 2.4 times higher for blood cancers, 2.2 times higher for gynecological cancer, and 57% higher for colorectal cancer, among others. Factors such as current smoking, heavy alcohol consumption, chronic liver disease, and chronic obstructive pulmonary disease (COPD) were identified as independent risk factors for cancer in TB patients.

The study’s lead researchers emphasized that TB acts as an independent risk factor for various types of cancer, beyond just lung cancer. They suggest that screening and proactive cancer management should be considered for individuals with a history of TB. Dr. Jiwon Kim from the National Health Insurance Service, Ilsan Hospital, Goyang, South Korea, and Dr. Jinnam Kim from Hanyang University College of Medicine, Seoul, South Korea, along with their colleagues, spearheaded this significant investigation.

This study underscores the critical need for increased awareness and monitoring of cancer risk in TB patients. The findings highlight the intricate relationship between TB and cancer, urging healthcare providers to prioritize cancer screening and prevention strategies for this vulnerable population. Further research and collaboration are essential to better understand and address the complex interplay between TB and cancer, ultimately improving outcomes for patients worldwide.

Cancer

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