title: Latent Tuberculosis Infection and the Risk of Subsequent Cancer.
abstract: The association of latent tuberculosis infection (LTBI) with subsequent cancer remains unclear. We investigated the risk of future cancer among tuberculosis (TB) contacts with or without subsequent TB activation. Using the Taiwan National Health Insurance Research Database, we conducted a nationwide population-based study. TB contacts during 1997 to 2012 were included as the study cohort. Patients with antecedent cancer and TB were excluded. Data from 11,522 TB contacts and 46,088 age-, sex-, and enrollment date-matched subjects during 1997 to 2012 were analyzed. The 2 cohorts were monitored until December 31, 2012 for incidence of cancer and TB infection. LTBI was defined as a TB contact with subsequent TB activation. The primary endpoint was occurrence of newly diagnosed cancer. There was no difference in cancer development between the TB contact cohort and comparison cohort (log-rank test, P = 0.714). After multivariate adjustment, the hazard ratio (HR) for cancer among the LTBI patients was 2.29 [95% confidence interval (CI), 1.26-4.17; P = 0.007]. There was increase in cancer incidences for several specific cancer types, including multiple myeloma (HR 340.28), lung (HR 2.69), kidney and bladder (HR 6.16), hepatobiliary (HR 2.36), and gastrointestinal (HR 2.99) cancers. None of the 136 TB contacts who received isoniazid prophylaxis developed cancer. LTBI patients had a higher risk of future cancer.
authors.affiliation: From the Department of Chest Medicine (VY-FS, S-WP, J-YF, K-TC, Y-MC, W-JS); Center for Prevention and Treatment of Occupational Injury and Disease (P-HC); Department of Family Medicine, Taipei Veterans General Hospital (T-JC); Section of Infectious Diseases, Taipei City Hospital, Taipei City Government (Y-FY); Institute of Clinical Medicine (VY-FS, K-TC); and School of Medicine, National Yang-Ming University, Taipei, Taiwan (VY-FS, Y-FY, S-WP, J-YF, K-TC, Y-MC, T-JC).
authors.forename: Vincent Yi-Fong
authors.initials: VY
authors.lastname: Su
authors.forename: Yung-Feng
authors.initials: YF
authors.lastname: Yen
authors.forename: Sheng-Wei
authors.initials: SW
authors.lastname: Pan
authors.forename: Pei-Hung
authors.initials: PH
authors.lastname: Chuang
authors.forename: Jia-Yih
authors.initials: JY
authors.lastname: Feng
authors.forename: Kun-Ta
authors.initials: KT
authors.lastname: Chou
authors.forename: Yuh-Min
authors.initials: YM
authors.lastname: Chen
authors.forename: Tzeng-Ji
authors.initials: TJ
authors.lastname: Chen
authors.forename: Wei-Juin
authors.initials: WJ
authors.lastname: Su
mesh_terms: D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D055985:Latent Tuberculosis / Q000188:drug therapy / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D000995:Antitubercular Agents; D007538:Isoniazid
references.citation: J Korean Med Sci. 2013 Jun;28(6):896-900
references.pmid: 23772155
references.citation: Int J Tuberc Lung Dis. 2014 Oct;18(10):1211-9
references.pmid: 25216835
references.citation: J Thorac Oncol. 2011 Jan;6(1):32-7
references.pmid: 21150470
references.citation: Eur Respir J. 2015 May;45(5):1501-4
references.pmid: 25700384
references.citation: Am J Epidemiol. 2012 Sep 1;176(5):409-22
references.pmid: 22791739
references.citation: Int J Cancer. 2009 Dec 15;125(12):2936-44
references.pmid: 19521963
references.citation: J Exp Med. 1999 Nov 15;190(10):1367-70
references.pmid: 10562311
references.citation: Biomed Pharmacother. 1985;39(2):49-51
references.pmid: 2990589
references.citation: Ann Intern Med. 2015 Jul 7;163(1):52-8
references.pmid: 25915859
references.citation: Cancer. 2011 Feb 1;117(3):618-24
references.pmid: 20886634
references.citation: Am J Epidemiol. 1989 Jan;129(1):212-9
references.pmid: 2910063
references.citation: Int J Cancer. 2015 Mar 1;136(5):E359-86
references.pmid: 25220842
references.citation: PLoS One. 2011 Mar 31;6(3):e17479
references.pmid: 21483846
references.citation: CMAJ. 2014 Apr 1;186(6):415-21
references.pmid: 24591276
references.citation: Mol Cancer Res. 2006 Apr;4(4):221-33
references.pmid: 16603636
references.citation: Hum Immunol. 2009 May;70(5):277-80
references.pmid: 19275919
references.citation: Nature. 2002 Dec 19-26;420(6917):860-7
references.pmid: 12490959
references.citation: Br J Cancer. 2013 Jul 9;109(1):229-34
references.pmid: 23652313
references.citation: Int J Cancer. 1996 Sep 17;67(6):892-7
references.pmid: 8824564