Coexistent Pulmonary Tuberculosis and Lung Cancer: An Analysis of Incidence Trends, Financial Burdens and Influencing Factors

ABSTRACT Background Tuberculosis (TB) and lung cancer (LC) are both major global health threats. However, coexistent pulmonary TB and LC (TBLC) is a unique condition for which incidence trends and risk factors have not been fully defined. Methods We retrospectively reviewed the medical records of pa...

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Main Authors: Fei Qi, Hongjie Yang, Yi Han, Yujie Dong, Fan Zhang, Yishuo Wang, Juan Du, Yuan Gao, Xueguang Hu, Liqun Zhang, Tongmei Zhang
Format: Article
Language:English
Published: Wiley 2025-06-01
Series:Cancer Innovation
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Online Access:https://doi.org/10.1002/cai2.70009
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author Fei Qi
Hongjie Yang
Yi Han
Yujie Dong
Fan Zhang
Yishuo Wang
Juan Du
Yuan Gao
Xueguang Hu
Liqun Zhang
Tongmei Zhang
author_facet Fei Qi
Hongjie Yang
Yi Han
Yujie Dong
Fan Zhang
Yishuo Wang
Juan Du
Yuan Gao
Xueguang Hu
Liqun Zhang
Tongmei Zhang
author_sort Fei Qi
collection DOAJ
description ABSTRACT Background Tuberculosis (TB) and lung cancer (LC) are both major global health threats. However, coexistent pulmonary TB and LC (TBLC) is a unique condition for which incidence trends and risk factors have not been fully defined. Methods We retrospectively reviewed the medical records of patients with TBLC and LC alone between 2010 and 2022 at Beijing Chest Hospital, the standard authority for the diagnosis and treatment of TB and LC in China. The cumulative incidence rate (CIR) of TBLC was calculated as the number of new TBLC cases/number of LC cases at risk per 100,000 annually. The comparative incidence rate ratio (IRR) was estimated to be the TB incidence in LC patients/TB incidence in the general population. Logistic regression was used to explore risk factors for TBLC. Results The CIR of TBLC has rapidly increased each year since 2014 and reached 7027 per 100,000 LC patients in 2022. Patients with LC had a higher risk of developing active TB than the general population (IRR = 25.21, 95% confidence interval [CI]: 21.54–29.89). Medical expenditure per patient was 100.60 thousand yuan for those with TBLC and 105.60 thousand yuan for patients with LC (p = 0.687). Patients with TBLC were older (63.61 ± 10.46 vs. 61.08 ± 10.77, p < 0.001) and had a higher male‐to‐female ratio (2.82 vs. 1.59, p = 0.044) than those with LC alone. A tendency of earlier disease onset was observed in patients with LC rather than TBLC. A majority (44.92%) of TBLC lesions were located in the upper lobes of the lung and had a higher proportion of squamous cell carcinomas than LC alone (32.24% vs. 27.49%, p = 0.002). TBLC also presented more aggressively, with more lymph node involvement and distant metastases. Multivariate analysis revealed that older age, the male sex, mediastinal lymph node invasion, lung/bone metastases, anemia, hypoalbuminemia, malnutrition, pulmonary fibrosis, and chronic obstructive pulmonary disease were risk factors for active TBLC. Conclusions There has been a rise in the incidence of coexistent TBLC and a concomitant increase in its financial burden in China that deserves more awareness and attention.
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spelling doaj-art-e1ca4db60ed140b492b6b7f1e6513bfb2025-08-20T03:53:52ZengWileyCancer Innovation2770-91912770-91832025-06-0143n/an/a10.1002/cai2.70009Coexistent Pulmonary Tuberculosis and Lung Cancer: An Analysis of Incidence Trends, Financial Burdens and Influencing FactorsFei Qi0Hongjie Yang1Yi Han2Yujie Dong3Fan Zhang4Yishuo Wang5Juan Du6Yuan Gao7Xueguang Hu8Liqun Zhang9Tongmei Zhang10General Department, Beijing Chest Hospital Capital Medical University (Beijing Tuberculosis and Thoracic Tumor Research Institute) Beijing ChinaGeneral Department, Beijing Chest Hospital Capital Medical University (Beijing Tuberculosis and Thoracic Tumor Research Institute) Beijing ChinaCardiothoracic Surgery Department, Affiliated Hospital of Shaanxi University of Chinese Medicine Shaanxi University of Chinese Medicine Xianyang Shaanxi ChinaPathology Department, Beijing Chest Hospital Capital Medical University (Beijing Tuberculosis and Thoracic Tumor Research Institute) Beijing ChinaGeneral Department, Beijing Chest Hospital Capital Medical University (Beijing Tuberculosis and Thoracic Tumor Research Institute) Beijing ChinaGeneral Department, Beijing Chest Hospital Capital Medical University (Beijing Tuberculosis and Thoracic Tumor Research Institute) Beijing ChinaPathology Department, Beijing Chest Hospital Capital Medical University (Beijing Tuberculosis and Thoracic Tumor Research Institute) Beijing ChinaGeneral Department, Beijing Chest Hospital Capital Medical University (Beijing Tuberculosis and Thoracic Tumor Research Institute) Beijing ChinaDepartment of Stomatology Shenzhen Guangming District People's Hospital Shenzhen Guangdong ChinaGuangzhou National Laboratory Guangzhou Guangdong ChinaGeneral Department, Beijing Chest Hospital Capital Medical University (Beijing Tuberculosis and Thoracic Tumor Research Institute) Beijing ChinaABSTRACT Background Tuberculosis (TB) and lung cancer (LC) are both major global health threats. However, coexistent pulmonary TB and LC (TBLC) is a unique condition for which incidence trends and risk factors have not been fully defined. Methods We retrospectively reviewed the medical records of patients with TBLC and LC alone between 2010 and 2022 at Beijing Chest Hospital, the standard authority for the diagnosis and treatment of TB and LC in China. The cumulative incidence rate (CIR) of TBLC was calculated as the number of new TBLC cases/number of LC cases at risk per 100,000 annually. The comparative incidence rate ratio (IRR) was estimated to be the TB incidence in LC patients/TB incidence in the general population. Logistic regression was used to explore risk factors for TBLC. Results The CIR of TBLC has rapidly increased each year since 2014 and reached 7027 per 100,000 LC patients in 2022. Patients with LC had a higher risk of developing active TB than the general population (IRR = 25.21, 95% confidence interval [CI]: 21.54–29.89). Medical expenditure per patient was 100.60 thousand yuan for those with TBLC and 105.60 thousand yuan for patients with LC (p = 0.687). Patients with TBLC were older (63.61 ± 10.46 vs. 61.08 ± 10.77, p < 0.001) and had a higher male‐to‐female ratio (2.82 vs. 1.59, p = 0.044) than those with LC alone. A tendency of earlier disease onset was observed in patients with LC rather than TBLC. A majority (44.92%) of TBLC lesions were located in the upper lobes of the lung and had a higher proportion of squamous cell carcinomas than LC alone (32.24% vs. 27.49%, p = 0.002). TBLC also presented more aggressively, with more lymph node involvement and distant metastases. Multivariate analysis revealed that older age, the male sex, mediastinal lymph node invasion, lung/bone metastases, anemia, hypoalbuminemia, malnutrition, pulmonary fibrosis, and chronic obstructive pulmonary disease were risk factors for active TBLC. Conclusions There has been a rise in the incidence of coexistent TBLC and a concomitant increase in its financial burden in China that deserves more awareness and attention.https://doi.org/10.1002/cai2.70009clinicopathological featuresincidencelung cancerpulmonary tuberculosisrisk factors
spellingShingle Fei Qi
Hongjie Yang
Yi Han
Yujie Dong
Fan Zhang
Yishuo Wang
Juan Du
Yuan Gao
Xueguang Hu
Liqun Zhang
Tongmei Zhang
Coexistent Pulmonary Tuberculosis and Lung Cancer: An Analysis of Incidence Trends, Financial Burdens and Influencing Factors
Cancer Innovation
clinicopathological features
incidence
lung cancer
pulmonary tuberculosis
risk factors
title Coexistent Pulmonary Tuberculosis and Lung Cancer: An Analysis of Incidence Trends, Financial Burdens and Influencing Factors
title_full Coexistent Pulmonary Tuberculosis and Lung Cancer: An Analysis of Incidence Trends, Financial Burdens and Influencing Factors
title_fullStr Coexistent Pulmonary Tuberculosis and Lung Cancer: An Analysis of Incidence Trends, Financial Burdens and Influencing Factors
title_full_unstemmed Coexistent Pulmonary Tuberculosis and Lung Cancer: An Analysis of Incidence Trends, Financial Burdens and Influencing Factors
title_short Coexistent Pulmonary Tuberculosis and Lung Cancer: An Analysis of Incidence Trends, Financial Burdens and Influencing Factors
title_sort coexistent pulmonary tuberculosis and lung cancer an analysis of incidence trends financial burdens and influencing factors
topic clinicopathological features
incidence
lung cancer
pulmonary tuberculosis
risk factors
url https://doi.org/10.1002/cai2.70009
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