title: Incidence of and Risk Factors for Tuberculosis (TB) in Gastric Cancer Patients in an Area Endemic for TB: A Nationwide Population-based Matched Cohort Study.
abstract: To date, there have been few reports investigating the relationship between tuberculosis (TB) and gastric cancer.We conducted a nationwide population-based matched cohort study using data retrieved from Taiwan's National Health Insurance Research Database to determine the incidence of and risk factors for TB in patients diagnosed with gastric cancer. From 2000 to 2011, we identified 36,972 gastric cancer patients and normal subjects from the general population matched for age, sex, and comorbidities at a 1:1 ratio. The data were analyzed using Cox proportional hazards models.Compared with the matched cohort, gastric cancer patients exhibited a higher risk for TB (adjusted hazard ratio [HR] 2.25, 95% confidence interval [CI] 1.65-3.05, P < 0.001), and those with TB exhibited higher mortality (adjusted HR 1.59, 95% CI 1.41-1.79, P < 0.001). Old age (adjusted HR 2.40, 95% CI 1.92-2.99, P < 0.001), male sex (adjusted HR 2.13, 95% CI 1.76-2.57, P < 0.001), diabetes mellitus (adjusted HR 1.28, 95% CI 1.05-1.56, P = 0.013), and chronic obstructive pulmonary disease (COPD) (adjusted HR 1.44, 95% CI 1.19-1.75, P < 0.001) were identified as independent risk factors for TB in gastric cancer patients. Dyslipidemia was an independent protective factor for both TB (adjusted HR 2.13, 95% CI 1.73-2.62, P < 0.001) and mortality (adjusted HR 1.11, 95% CI 1.08-1.15, P < 0.001) in gastric cancer patients.Old age, male sex, diabetes mellitus, and COPD were independent risk factors for TB in gastric cancer. High-risk gastric cancer patients, especially those in TB-endemic areas, should be regularly screened for TB.
authors.affiliation: From the Division of General Surgery, Department of Surgery (W-LF, K-HH, Y-MS, C-WW), Division of Gastroenterology, Department of Medicine (Y-PH, YC), Division of Hematology and Oncology, Department of Medicine (Y-PH, C-JL, M-HC, M-HY), Division of Colon and Rectal Surgery, Department of Surgery (Y-TL), Department of Family Medicine (T-JC), and Department of Oncology (YC), Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine (W-LF, Y-PH, C-JL, Y-TL, K-HH, M-HC, S-SL, Y-MS, C-WW, M-HY, T-JC, YC), Institute of Public Health (Y-PH), and Institute of Clinical Medicine, School of Medicine (K-HH, M-HY), National Yang-Ming University, Taipei, Taiwan; National Yang-Ming University Hospital, Yilan City, Taiwan (S-SL).
authors.forename: Wen-Liang
authors.initials: WL
authors.lastname: Fang
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Hung
authors.forename: Chia-Jen
authors.initials: CJ
authors.lastname: Liu
authors.forename: Yuan-Tzu
authors.initials: YT
authors.lastname: Lan
authors.forename: Kuo-Hung
authors.initials: KH
authors.lastname: Huang
authors.forename: Ming-Huang
authors.initials: MH
authors.lastname: Chen
authors.forename: Su-Shun
authors.initials: SS
authors.lastname: Lo
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Shyr
authors.forename: Chew-Wun
authors.initials: CW
authors.lastname: Wu
authors.forename: Muh-Hwa
authors.initials: MH
authors.lastname: Yang
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.forename: Yee
authors.initials: Y
authors.lastname: Chao
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000401:mortality; D013624:Taiwan / Q000453:epidemiology; D014376:Tuberculosis / Q000453:epidemiology*