Department of Global Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Division of Cancer Statistics Integration, Center for Cancer Control and Information Services, National Cancer Center, Tokyo, Japan.
BMC Cancer. 2020 May 12;20(1):412. doi: 10.1186/s12885-020-06891-5.
Tuberculosis is associated with increased risk of cancer. However, the impact of tuberculosis on global cancer burden is unknown.
We 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).
Fourty 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.
Tuberculosis 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.
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。
我们通过搜索 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了随机效应荟萃分析和荟萃回归分析。使用荟萃分析中的相对风险和全球卫生数据交换中的结核病患病率数据，按年龄、性别和国家计算归因于结核病的癌症发病率的人群归因分数（PAF）。该研究已在 PROSPERO（CRD42016050691）中注册。
符合预先规定纳入标准的 49 项研究共纳入 52480 例癌症病例。结核病与头颈部癌症（RR 2.64[95%CI 2.00-3.48]）、肝胆癌症（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]）、胃肠道癌症（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]）、肾脏和膀胱癌（1.54[1.21-1.97]）以及卵巢癌（1.43[1.04-1.97]）有关。我们估计，2015 年全球癌症发病率的 2.33%（1.14-3.81）或 381035 例（187145-623404）归因于结核病。PAF 因社会人口指数（SDI）而异-高 SDI 国家为 1.28%（0.57-2.31%），中 SDI 国家为 3.51%（1.84-5.42%）。单独来看，中国和印度占所有与结核病相关的癌症病例的 47%。
结核病与 10 个部位的癌症风险增加有关。归因于结核病的癌症负担偏向资源较少的国家。研究重点是更好地了解结核病和癌症发展之间的区域差异和潜在机制。
