Management of co-existent tuberculosis and lung cancer

Tuberculosis (TB) and lung cancer are important global health threats, each accounting for 1.6 million deaths yearly. The incidence of both conditions remains high in many developing countries, especially in East Asia. There is now epidemiologic evidence that pre-existing TB poses an increased lung cancer risk. The clinical diagnosis of co-existent TB and lung cancer relies on symptoms of infection, typical radiological features and microbiological confirmation, and remains a challenge in both early and late stage lung cancer. The presence of histological granulomatous inflammation in resected lung specimens is not exclusively indicative of TB. The widely accepted systemic chemotherapy and immunotherapy for treating lung cancer are highly relevant to the occurrence of TB and its management. This review addresses the clinical approach to the diagnosis and treatment of TB that co-exists with lung cancer.