Abstract / Summary
Abstract Purpose The most common cause of cancer-related death in the world is lung cancer. It has been suggested that pulmonary tuberculosis (TB), which is caused by immunological dysregulation, scarring, and persistent pulmonary inflammation, is a separate risk factor for lung cancer. An updated analysis is necessary due to methodological limitations, such as improper pooling of heterogenous effect measures and insufficient control for detection bias. Previous meta-analyses have reported a significant association. Using a methodologically rigorous approach, this meta-analysis is sought to estimate the pooled association between TB and lung cancer risk across cohort and case-control studies. Methods A thorough search of Google Scholar and PubMed turned up 4,275 records. Nine studies (8 cohort, 1 case-control; total N = 1,012,061) met predetermined eligibility criteria after duplicate removal and screening. A random-effects model with generic inverse-variance weighting on the log scale was used to aggregate effect estimates. Using the Newcastle-Ottawa Scale, study quality was evaluated. Results Pulmonary TB was significantly associated with increased lung cancer risk (pooled effect estimate: 2.39, 95% CI: 1.91–2.99, p < 0.0001). Substantial heterogeneity was observed (I 2 = 88.7%). The association remained consistent across subgroup & sensitivity analyses. Conclusion Lung cancer is roughly 2.4 times higher in those with a history of pulmonary tuberculosis. These results emphasize the need for prospective studies to elucidate underlying mechanisms and support incorporating lung cancer surveillance into post-TB care pathways.