Cancer incidence attributable to tuberculosis in 2015: global, regional, and national estimates
Cancer incidence attributable to tuberculosis in 2015: global, regional, and national estimates
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DOI：
10.1186/s12885-020-06891-5
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发表时间：
2020-05-12
期刊：
影响因子：
3.8
通讯作者：
Shibuya, Kenji
中科院分区：
文献类型：
--
作者：
Leung, Chi Yan;Huang, Hsi-Lan;Shibuya, Kenji
结核病与癌症风险增加有关。然而，结核病对全球癌症负担的影响尚不清楚。方法通过检索PubMed、Web of Science、Embase、Cochrane图书馆和CINAHL，从成立到2019年6月1日，对报告结核病与癌症风险之间关联的研究进行随机效应荟萃分析和荟萃回归。根据meta分析的相对风险和全球健康数据交换（Global Health data Exchange）按年龄、性别和国家分类的结核病患病率数据，计算结核病导致的癌症发病率的人口归因分数（paf）。该研究已在PROSPERO注册（CRD42016050691）。结果49项研究52480例癌症病例符合预先设定的纳入标准。结核病与头颈癌（RR 2.64[95% CI 2.00-3.48]）、肝胆癌（2.43[1.82-3.25]）、霍奇金淋巴瘤（2.19[1.62-2.97]）、肺癌（1.69[1.46-1.95]）、胃肠道癌（1.62[1.26-2.08]）、非霍奇金淋巴瘤（1.61[1.34-1.94]）、胰腺癌（1.58[1.28-1.96]）、白血病（1.55[1.25-1.93]）、肾癌和膀胱癌（1.54[1.21-1.97]）、卵巢癌（1.43[1.04-1.97]）相关。我们估计2015年全球癌症发病率的2.33%（1.14-3.81）或381,035（187145-623,404）可归因于结核病。paf因社会人口指数（SDI）而异，从高SDI国家的1.28%（0.57-2.31%）到中等SDI国家的3.51%（1.84-5.42%）不等。单独来看，中国和印度占所有结核病相关癌症病例的47%。结论结核与10个部位的癌症风险增加有关。结核病引起的癌症负担向资源较低的国家倾斜。研究重点是更好地了解区域差异和联系结核病和癌症发展的潜在机制。
BackgroundTuberculosis is associated with increased risk of cancer. However, the impact of tuberculosis on global cancer burden is unknown.MethodsWe performed random-effects meta-analyses and meta-regressions of studies reporting the association between tuberculosis and cancer risks by searching PubMed, Web of Science, Embase, Cochrane library, and CINAHL from inception to 1 June 2019. Population attributable fractions (PAFs) of cancer incidence attributable to tuberculosis were calculated using relative risks from our meta-analyses and tuberculosis prevalence data from Global Health Data Exchange by age, sex, and country. The study has been registered with PROSPERO (CRD42016050691).ResultsFourty nine studies with 52,480 cancer cases met pre-specified inclusion criteria. Tuberculosis was associated with head and neck cancer (RR 2.64[95% CI 2.00-3.48]), hepatobiliary cancer (2.43[1.82-3.25]), Hodgkin's lymphoma (2.19[1.62-2.97]), lung cancer (1.69[1.46-1.95]), gastrointestinal cancer (1.62[1.26-2.08]), non-Hodgkin's lymphoma (1.61[1.34-1.94]), pancreatic cancer (1.58[1.28-1.96]), leukaemia (1.55[1.25-1.93]), kidney and bladder cancer (1.54[1.21-1.97]), and ovarian cancer (1.43[1.04-1.97]). We estimated that 2.33%(1.14-3.81) or 381,035(187145-623,404) of global cancer incidences in 2015 were attributable to tuberculosis. The PAFs varied by Socio-demographic Index (SDI)-ranging from 1.28% (0.57-2.31%) in the high-SDI countries to 3.51% (1.84-5.42%) in the middle-SDI countries. Individually, China and India accounted for 47% of all tuberculosis-related cancer cases.ConclusionsTuberculosis is associated with increased risk of cancer at ten sites. The burden of tuberculosis attributable cancer skewed towards lower resource countries. Research priorities are to better understand regional disparities and underlying mechanism linking tuberculosis and cancer development.