Pulmonary Tuberculosis and Risk of Lung Cancer: A Systematic Review and Meta-Analysis.

Abstract

Introduction: Lung cancer is a leading cause of cancer-related deaths worldwide, with rising incidence in resource-limited settings. Research suggests an increased risk of lung cancer in individuals with a history of pulmonary tuberculosis (TB), but the association needs further clarification. This systematic review aims to provide a more comprehensive understanding of this relationship.

Methods: We systematically searched the PubMed/Medline, EMBASE, and Scopus databases for relevant studies up to March 15, 2024. The quality of the included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklist. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using either random-effects or fixed-effects models, depending on the level of heterogeneity. All statistical analyses were performed using Comprehensive Meta-Analysis software, version 3.0.

Results: A total of 37 studies were included (9 cohort and 28 case-control). A significant association between prior pulmonary TB and lung cancer was found in both cohort (OR: 2.3; 95% CI, 1.4-3.8) and case-control (OR: 1.9; 95% CI, 1.4-2.5) studies. Subgroup analyses revealed a stronger association in East Asia (OR: 2.4; 95% CI, 1.3-4.1).

Conclusion: Our study provides strong evidence of an increased risk of lung cancer following pulmonary TB. The findings emphasize the need for comprehensive public health strategies, including targeted screening, early detection, and smoking cessation. Future studies should investigate the mechanisms linking TB and lung cancer, as well as the effectiveness of integrated prevention programs, particularly in high-burden regions.