Lung Cancer Risk Factors Associated with Tuberculosis
Summary
Population studies and mechanistic research have identified pulmonary tuberculosis as an independent risk factor for lung cancer. Residual scarring and chronic inflammation arising from healed mycobacterial lesions promote fibrotic changes, alter the local immune microenvironment and stimulate oncogenic signalling. Fibrotic scars may serve as a niche for malignant transformation through aberrant repair pathways and disrupted cell adhesion. Simultaneously, persistent immune activation and altered macrophage phenotypes contribute to a pro-tumourigenic milieu. Cohort analyses consistently report a two- to threefold elevation in lung cancer risk among individuals with prior tuberculosis, independent of smoking history. Younger patients and regions with higher tuberculosis burden appear particularly susceptible. Recognition of this association has implications for surveillance strategies in tuberculosis survivors and highlights potential targets within macrophage-driven inflammation and fibrogenic processes for early intervention.
Research from Nature Portfolio
A large cohort study examined the burden of tuberculosis in individuals with respiratory malignancies. Findings indicated that the incidence of tuberculosis among cancer patients rose steadily over fifteen years, with the highest standard incidence ratios observed in respiratory tract malignancies. Tuberculosis diagnosis carried a substantial impact on both short-term mortality and two-year recurrence rates, emphasising the need for integrated management of mycobacterial infection in cancer care. The analysis underscored that co-existing tuberculosis not only complicates oncological outcomes but also contributes to elevated all-cause mortality, advocating for enhanced screening and multidisciplinary treatment pathways.
Lung Cancer Risk Factors Associated with Tuberculosis publication trend
The graph below shows the total number of articles in lung cancer risk factors associated with tuberculosis across all publications each year (not limited to Nature Index journals).
Technical terms
Fibrosis: Excessive deposition of connective tissue leading to scarring of lung parenchyma.
Autophagy: Intracellular process of self-digestion that can promote cancer cell survival under stress.
Macrophage polarisation: Differentiation of macrophages into pro-inflammatory (M1) or anti-inflammatory/tumour-promoting (M2) phenotypes.
E-cadherin: Cell-adhesion protein whose loss facilitates tumour invasion and metastasis.
Arginase-1 (Arg-1): Enzyme expressed by M2 macrophages that regulates arginine metabolism and supports tumour growth.
Standard incidence ratio (SIR): Ratio of observed to expected cases of a disease in a specific population.
References
- New progress of tuberculosis scar carcinoma. Cancer and Metastasis Reviews (2023).
- Tuberculous pleural effusion-induced Arg-1+ macrophage polarization contributes to lung cancer progression via autophagy signaling. Respiratory Research (2024).
- The burdens of tuberculosis on patients with malignancy: incidence, mortality and relapse. Scientific Reports (2019).
- Pulmonary Tuberculosis and Risk of Lung Cancer: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine (2022).
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