癌症与结核病风险的时间依赖性关联：基于人群的队列研究。

Time-dependent association between cancer and risk of tuberculosis: A population-based cohort study.

机构信息

Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City 100, Taiwan; Department of Radiation Oncology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City 243, Taiwan; School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City 242, Taiwan.

Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City 100, Taiwan.

出版信息

Int J Infect Dis. 2021 Jul;108:340-346. doi: 10.1016/j.ijid.2021.05.037. Epub 2021 May 19.

DOI:10.1016/j.ijid.2021.05.037

PMID:34022337

Abstract

BACKGROUND

We aimed to investigate the time-dependent association between cancer and the risk of tuberculosis (TB) before and after cancer diagnosis.

METHODS

This population-based cohort study incorporated the National Health Insurance Research Database and the National Health Interview Survey in Taiwan to estimate TB risk in cancer and noncancer populations. We estimated the period-specific incidence rate ratio (IRR) between cancer and risk of TB and used Cox proportional hazards models to estimate the average hazard ratio between cancer and TB during the peridiagnostic period.

RESULTS

From 2001 to 2015, 457 673 cancer and 3 738 122 noncancer individuals were enrolled. After stratifying the IRR of TB by year relative to the date of cancer diagnosis, the peak IRRs clustered in the year before and after the index date. In the peridiagnostic period of cancer, the adjusted hazard ratio was 2.29 (95% CI, 2.22-2.35) using the Cox model and 2.20 (95% CI, 2.09-2.32) after adjustment for missing confounders. Patients with cancers in the respiratory tract, upper digestive tract, and hematologic system were at the highest risk for TB.

CONCLUSIONS

Cancer is an independent risk factor for TB, with the highest risk observed around the time of cancer diagnosis.

摘要

背景

本研究旨在探讨癌症诊断前后癌症与结核病（TB）风险之间的时间依赖性关联。

方法

本基于人群的队列研究纳入了台湾全民健康保险研究数据库和全国健康访谈调查，以估计癌症和非癌症人群的 TB 风险。我们估计了癌症和 TB 之间的特定时期发生率比（IRR），并使用 Cox 比例风险模型估计了诊断前期间癌症和 TB 之间的平均风险比。

结果

在 2001 年至 2015 年期间，纳入了 457673 例癌症和 3738122 例非癌症患者。按癌症诊断日期相对年份对 TB 的 IRR 进行分层后，峰值 IRR 聚集在指数日期的前一年和后一年。在癌症的诊断前期间，使用 Cox 模型的调整后风险比为 2.29（95%CI，2.22-2.35），在调整缺失混杂因素后为 2.20（95%CI，2.09-2.32）。患有呼吸道、上消化道和血液系统癌症的患者患 TB 的风险最高。