Tuberculosis and risk of cancer: A systematic review and meta-analysis

Abstract

Introduction Cancer is a major cause of death among people who experience tuberculosis (TB), but little is known about its timing and incidence following TB treatment. Our primary objectives were to estimate the pooled risk of all and site-specific malignancies in people with TB compared to the general population or suitable controls. Our secondary objective was to describe the pooled risk of cancer at different time points following TB diagnosis. Methods This study was prospectively registered (PROSPERO: CRD42021277819). We systematically searched MEDLINE, Embase, and the Cochrane Database for studies published between 1980 and 2021. We included original observational research articles that estimated cancer risk among people with TB compared to controls. Studies were excluded if they had a study population of fewer than 50 individuals; used cross-sectional, case series, or case report designs; and had a follow-up period of less than 12 months. Random-effects meta-analysis was used to obtain the pooled risk of cancer in the TB population. Results Of the 5,160 unique studies identified, data from 17 studies were included. When compared to controls, the pooled standardized incidence ratios (SIR) of all cancer (SIR 1.62, 95% CI 1.35–1.93, I2 = 97%) and lung cancer (SIR 3.20, 95% CI 2.21–4.63, I2 = 90%) was increased in the TB population. The pooled risk of all cancers and lung cancer was highest within the first year following TB diagnosis (SIR 4.70, 95% CI 1.80–12.27, I2 = 99%) but remained over five years of follow-up. Conclusions People with TB have an increased risk of both pulmonary and non-pulmonary cancers. Further research on cancer following TB diagnosis is needed to develop effective screening and early detection strategies. Clinicians should have a high index of suspicion for cancer in people with TB, particularly in the first year following TB diagnosis.

Rapidly growing adenosquamous carcinoma in the pancreatic tail discovered upon its resection for cervical tuberculous lymphadenitis: A case report

“…Individuals with tuberculosis have an increased risk of both pulmonary and non-pulmonary cancer [7].…”

“…[6] and Luczynski et al [7] reported that tuberculosis is associated with an increased risk of pancreatic cancer. However, the factors contributing to the development of adenosquamous carcinoma after Mycobacterium tuberculosis infection remain unclear.…”

“…Luczynski et al [7] showed that tuberculosis was associated with an increased pooled standard incidence ratio (SIR) of pancreatic cancer (Relative risk [RR]: 1.58, 95% con dence interval [CI]: 1.29-1.93, I 2 = 0%). Additionally, Leung et al [6], in a meta-analysis, found that tuberculosis was associated with an increased risk for ten cancer types: head and neck, hepatobiliary, lung, gastrointestinal, pancreatic, kidney and bladder, and ovarian cancer, along with Hodgkin and non-Hodgkin lymphoma, and leukemia.…”

“…Additionally, Leung et al [6], in a meta-analysis, found that tuberculosis was associated with an increased risk for ten cancer types: head and neck, hepatobiliary, lung, gastrointestinal, pancreatic, kidney and bladder, and ovarian cancer, along with Hodgkin and non-Hodgkin lymphoma, and leukemia. Moreover, Luczynski et al [7] indicated that the SIR of all cancers was highest within the rst year following tuberculosis infection (SIR: 4.70, 95% CI: 1.80-12.27, I 2 = 99%). Thus, it is crucial to monitor carcinogenesis and cancer development, including pancreatic cancer, within the rst year of tuberculosis infection.…”