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Title: Tuberculosis and subsequent risk of lung cancer in Xuanwei, China

Abstract

Tobacco and indoor air pollution from smoky coal are major causes of lung cancer in rural Xuanwei County, China. Tuberculosis has been suggested to increase lung cancer risk, but data from prior studies are limited. We conducted an analysis of data from a retrospective cohort study of 42,422 farmers in Xuanwei. In 1992, interviewers administered a standardized questionnaire that included lifetime medical history, including tuberculosis. Subjects were followed from 1976, with deaths from lung cancer ascertained through 1996. We used proportional hazards regression to assess the association between tuberculosis and subsequent lung cancer mortality. Tuberculosis was reported by 246 subjects (0.6%), and 2,459 (5.8%) died from lung cancer during follow-up. Lung cancer mortality was substantially higher in subjects with tuberculosis than in those without (25 vs. 3.1 per 1,000 person-years). The association was especially pronounced in the first 5 years after tuberculosis diagnosis (hazard ratios (HRs) ranging 6.7-13) but remained strong 5-9.9 years (HR 3.4, 95% CI 1.3-9.1) and 10+ years (HR 3.0, 95% CI 1.3-7.3) after tuberculosis. These associations were similar among men and women and among smoky coal users (70.5% of subjects). Adjustment for demographic characteristics, lung disease and tobacco use did not affect results. In Xuanwei, China,more » tuberculosis is an important risk factor for lung cancer. The increased lung cancer risk, persisting years after a tuberculosis diagnosis, could reflect the effects of chronic pulmonary inflammation and scarring arising from tuberculosis.« less

Authors:
; ; ; ; ; ;  [1]
  1. NCI, Rockville, MD (USA). Infectious and Immunoepidemiology Branch
Publication Date:
OSTI Identifier:
21150650
Resource Type:
Journal Article
Journal Name:
International Journal of Cancer
Additional Journal Information:
Journal Volume: 124; Journal Issue: 5; Journal ID: ISSN 0020-7136
Country of Publication:
United States
Language:
English
Subject:
01 COAL, LIGNITE, AND PEAT; LUNGS; NEOPLASMS; CHINA; TUBERCULOSIS; TOBACCO SMOKES; COAL; COMBUSTION PRODUCTS; INDOOR AIR POLLUTION; EPIDEMIOLOGY; ADULTS; MORTALITY; CORRELATIONS; INFLAMMATION

Citation Formats

Engels, E A, Shen, M, Chapman, R S, Pfeiffer, R M, Yu, Y Y, He, X Z, and Lan, Q. Tuberculosis and subsequent risk of lung cancer in Xuanwei, China. United States: N. p., 2009. Web. doi:10.1002/ijc.24042.
Engels, E A, Shen, M, Chapman, R S, Pfeiffer, R M, Yu, Y Y, He, X Z, & Lan, Q. Tuberculosis and subsequent risk of lung cancer in Xuanwei, China. United States. https://doi.org/10.1002/ijc.24042
Engels, E A, Shen, M, Chapman, R S, Pfeiffer, R M, Yu, Y Y, He, X Z, and Lan, Q. Sun . "Tuberculosis and subsequent risk of lung cancer in Xuanwei, China". United States. https://doi.org/10.1002/ijc.24042.
@article{osti_21150650,
title = {Tuberculosis and subsequent risk of lung cancer in Xuanwei, China},
author = {Engels, E A and Shen, M and Chapman, R S and Pfeiffer, R M and Yu, Y Y and He, X Z and Lan, Q},
abstractNote = {Tobacco and indoor air pollution from smoky coal are major causes of lung cancer in rural Xuanwei County, China. Tuberculosis has been suggested to increase lung cancer risk, but data from prior studies are limited. We conducted an analysis of data from a retrospective cohort study of 42,422 farmers in Xuanwei. In 1992, interviewers administered a standardized questionnaire that included lifetime medical history, including tuberculosis. Subjects were followed from 1976, with deaths from lung cancer ascertained through 1996. We used proportional hazards regression to assess the association between tuberculosis and subsequent lung cancer mortality. Tuberculosis was reported by 246 subjects (0.6%), and 2,459 (5.8%) died from lung cancer during follow-up. Lung cancer mortality was substantially higher in subjects with tuberculosis than in those without (25 vs. 3.1 per 1,000 person-years). The association was especially pronounced in the first 5 years after tuberculosis diagnosis (hazard ratios (HRs) ranging 6.7-13) but remained strong 5-9.9 years (HR 3.4, 95% CI 1.3-9.1) and 10+ years (HR 3.0, 95% CI 1.3-7.3) after tuberculosis. These associations were similar among men and women and among smoky coal users (70.5% of subjects). Adjustment for demographic characteristics, lung disease and tobacco use did not affect results. In Xuanwei, China, tuberculosis is an important risk factor for lung cancer. The increased lung cancer risk, persisting years after a tuberculosis diagnosis, could reflect the effects of chronic pulmonary inflammation and scarring arising from tuberculosis.},
doi = {10.1002/ijc.24042},
url = {https://www.osti.gov/biblio/21150650}, journal = {International Journal of Cancer},
issn = {0020-7136},
number = 5,
volume = 124,
place = {United States},
year = {2009},
month = {3}
}