title: Cancer-specific incidence rates of tuberculosis: A 5-year nationwide population-based study in a country with an intermediate tuberculosis burden.
abstract: Population-based studies of the incidence of tuberculosis in cancer patients according to the type of cancer are limited. We investigated the cancer-specific incidence of tuberculosis in a nationwide population-based cohort in a country with an intermediate burden of tuberculosis.We used mandatory National Health Insurance claims data to construct a cancer cohort of adults (aged 20-99 years) with newly diagnosed malignancies other than lung cancer, from January 2008 to December 2012. Patients who developed tuberculosis in this period were identified in the cancer cohort and the general population. Standardized incidence ratios (SIRs) of tuberculosis in the cancer cohort according to type of cancer and time after cancer diagnosis were calculated by comparing the observed incidence rates with those inferred from the age- and gender-specific incidence rates in the general population.A total of 855,382 cancer patients and 1589,876 person-years (py) were observed. A total of 5745 patients developed tuberculosis; the mean incidence rate was 361.3 per 100,000 py, and the SIR was 2.22 (95% confidence interval [CI], 2.17-2.27). The incidence rate was highest for hematologic malignancy and lowest for thyroid cancer. It was also highest as 650.1 per 100,000 py, with SIR of 3.70 (CI, 3.57-3.83) for the first 6 months after diagnosis of malignancy and then declined. However, it still remained higher than that of the general population after 24 months (SIR = 1.43, CI, 1.36-1.51).The incidence of tuberculosis increases after diagnosis in patients with malignancies. The risk of tuberculosis differs according to the type of cancer and remains elevated even 24 months after cancer diagnosis. Tuberculosis should be considered an important comorbidity in patients with malignancies.
authors.affiliation: Evidence-based Healthcare Division, Health Insurance Review & Assessment Service, Seoul Division of Infectious Diseases Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
authors.forename: Gi Hyeon
authors.initials: GH
authors.lastname: Seo
authors.forename: Min Jae
authors.initials: MJ
authors.lastname: Kim
authors.forename: Soyoung
authors.initials: S
authors.lastname: Seo
authors.forename: Boram
authors.initials: B
authors.lastname: Hwang
authors.forename: Eugene
authors.initials: E
authors.lastname: Lee
authors.forename: Yujin
authors.initials: Y
authors.lastname: Yun
authors.forename: Minsun
authors.initials: M
authors.lastname: Choi
authors.forename: Moonsuk
authors.initials: M
authors.lastname: Kim
authors.forename: Jin Won
authors.initials: JW
authors.lastname: Kim
authors.forename: Eu Suk
authors.initials: ES
authors.lastname: Kim
authors.forename: Hong Bin
authors.initials: HB
authors.lastname: Kim
authors.forename: Kyoung-Ho
authors.initials: KH
authors.lastname: Song
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014376:Tuberculosis / Q000150:complications / Q000453:epidemiology*; D055815:Young Adult