Lung cancer occurrence after an episode of tuberculosis: a systematic review and meta-analysis.
Lung cancer occurrence after an episode of tuberculosis: a systematic review and meta-analysis.
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DOI：
10.1183/16000617.0025-2022
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发表时间：
2022-09-30
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结核病患者会经历无法治愈的长期健康影响，包括慢性呼吸道疾病。我们调查了肺结核是否是随后肺癌的危险因素。我们检索了PubMed、Scopus、科克伦、拉丁美洲和加勒比健康科学文献和科学电子图书馆在线，以获得队列和病例对照研究，这些研究提供了结核病与随后的肺癌之间关系的效果估计。我们通过随机效应荟萃分析汇总了估计值。该研究已在PROSPERO中注册（CDR 42020178362）。在6240份记录中，我们纳入了29项队列研究和44项病例对照研究。经年龄和吸烟校正的汇总估计值（定量评估）为风险比（HR）1.51（95% CI 1.30-1.76，I2=81%; 5项研究）和OR 1.74（95% CI 1.42-2.13，I2=59%; 19项研究）。肺癌的发生率在结核病诊断后2年内增加（HR 5.01，95% CI 3.64-6.89; 2项研究），但此后下降。 大多数研究是回顾性的，有中度到高度的偏倚风险，并且没有控制被动吸烟，环境暴露和社会经济地位。异质性很高。我们记录了结核病和肺癌发生之间的关联，特别是在结核病诊断后的前2年，但不限于此。 一些癌症病例在结核病诊断时可能已经存在，因此无法确定因果关系。需要进行控制关键混杂因素的前瞻性研究，以确定哪些结核病患者风险最高，以及降低此类风险的成本效益方法。在肺结核发作后，一个人比一般人群更有可能被诊断患有肺癌。这在结核病诊断后的头2年内最为明显，但因果关系无法确定。 https://bit.ly/38I4HMc
People with tuberculosis experience long-term health effects beyond cure, including chronic respiratory diseases. We investigated whether tuberculosis is a risk factor for subsequent lung cancer. We searched PubMed, Scopus, Cochrane, Latin American and Caribbean Health Sciences Literature and the Scientific Electronic Library Online for cohort and case–control studies providing effect estimates for the association between tuberculosis and subsequent lung cancer. We pooled estimates through random-effects meta-analysis. The study was registered in PROSPERO (CDR42020178362). Out of 6240 records, we included 29 cohort and 44 case–control studies. Pooled estimates adjusted for age and smoking (assessed quantitatively) were hazard ratio (HR) 1.51 (95% CI 1.30–1.76, I2=81%; five studies) and OR 1.74 (95% CI 1.42–2.13, I2=59%; 19 studies). The occurrence of lung cancer was increased for 2 years after tuberculosis diagnosis (HR 5.01, 95% CI 3.64–6.89; two studies), but decreased thereafter. Most studies were retrospective, had moderate to high risk of bias, and did not control for passive smoking, environmental exposure and socioeconomic status. Heterogeneity was high. We document an association between tuberculosis and lung cancer occurrence, particularly in, but not limited to, the first 2 years after tuberculosis diagnosis. Some cancer cases may have been present at the time of tuberculosis diagnosis and therefore causality cannot be ascertained. Prospective studies controlling for key confounding factors are needed to identify which tuberculosis patients are at the highest risk, as well as cost-effective approaches to mitigate such risk. After an episode of tuberculosis, an individual is more likely to be diagnosed with lung cancer than a person in the general population. This is most marked within the first 2 years after a tuberculosis diagnosis, but a causal relation cannot be ascertained. https://bit.ly/38I4HMc
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影响因子：
3.7
作者：
Hovanec J;Siemiatycki J;Conway DI;Olsson A;Stücker I;Guida F;Jöckel KH;Pohlabeln H;Ahrens W;Brüske I;Wichmann HE;Gustavsson P;Consonni D;Merletti F;Richiardi L;Simonato L;Fortes C;Parent ME;McLaughlin J;Demers P;Landi MT;Caporaso N;Tardón A;Zaridze D;Szeszenia-Dabrowska N;Rudnai P;Lissowska J;Fabianova E;Field J;Dumitru RS;Bencko V;Foretova L;Janout V;Kromhout H;Vermeulen R;Boffetta P;Straif K;Schüz J;Kendzia B;Pesch B;Brüning T;Behrens T
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影响因子：
3.8
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Ji DM
影响因子：
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Hosgood, H. Dean, III;Chapman, Robert S.;He, Xingzhou;Hu, Wei;Tian, Linwei;Liu, Larry Z.;Lai, Hong;Chen, Wei;Rothman, Nathaniel;Lan, Qing
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Lan, Qing
影响因子：
10
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Floe, Andreas;Hilberg, Ole;Lokke, Anders
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Lokke, Anders
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3.9
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