Abstract
BackgroundTuberculosis (TB) may facilitate carcinogenesis. We performed a case-control study of the association between TB and cancer in Xinjiang, a high TB endemic area of China.MethodsFrom January 2016 to December 2018, a total of 45,455 patients hospitalized in Xinjiang Cancer Hospital were consecutively enrolled and divided into a malignant tumor group (n = 32,539) and a benign tumor group (n = 12,916). Patients with active and previous TB before the diagnosis of cancer were retrospectively identified in the two groups.ResultsA significantly higher proportion of TB was found in the malignant tumor group (n = 1776, 5.46%) than in the control (benign tumor) group (n = 175, 1.35%) (p < 0.0001). The highest and lowest proportions of TB in the malignant group were in patients with non-Hodgkin’s lymphoma (16.74%) and thyroid cancer (0.77%), respectively. In multivariate analysis adjusting for age, sex, and ethnicity, TB remained an independent risk factor for all cancers (odds ratio (OR) 1.68; 95% confidence interval (CI) 1.43–1.97). Furthermore, TB was associated with a significantly higher risk of non-Hodgkin’s lymphoma, cervical cancer, esophageal cancer, “other” cancers, ovarian cancer, and breast cancer. Moreover, females with TB were more likely to develop cancer than males (p < 0.0001), except for esophageal cancer and lymphoma.ConclusionTB patients have an elevated cancer risk. A screening strategy for TB should be taken into consideration before treatment in patients with some cancer types that are associated with a high proportion of TB.
Highlights
TB occurred more frequently in malignant cancer than in benign tumor patients To assess the relationship between TB and tumors, we assigned the inpatients to two groups: the control group and the study group
No significant difference in the proportion of TB was found between patients of Han and non-Han ethnicities
We found a greater proportion of patients with malignant cancers than of those with benign tumors who had a previous TB
Summary
We performed a case-control study of the association between TB and cancer in Xinjiang, a high TB endemic area of China. Tuberculosis (TB) is an old disease that has affected humans more than 8000 years ago [1, 2]. In 2015, the agestandardized tuberculosis incidence rates (per 100 000 people) among men and women were 154.4 (140.0– 172.2) and 86.3 (78.0–97.4), respectively [4]. Western China is a high endemic area for TB [6, 7]. The patient diagnosis rate of pulmonary TB was 0.34 (95% confidence interval (CI) 0.25–0.44) in the 2010– 2011 Xinjiang survey [6]. The burden of multidrug-resistant and extensively drug-resistant TB cases was found to be substantial in the Xinjiang area [7].
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