Tuberculosis Preceding Lung Cancer: A Contemporary Meta-Analysis Revealing a Critical Gap in Post-2020 Evidence

Area of Science:

• Oncology
• Infectious Diseases
• Epidemiology

Background:

• Tuberculosis (TB) is a suspected contributor to lung carcinogenesis via chronic inflammation.
• Limited contemporary controlled evidence quantifies the association between prior TB and lung cancer.
• This study systematically evaluates the relationship between prior TB and subsequent lung malignancy.

Purpose of the Study:

• To systematically evaluate the relationship between prior tuberculosis and subsequent lung malignancy.
• To quantify the association using recent observational studies and case reports.
• To identify research gaps in understanding TB as an independent risk factor for lung cancer.

Main Methods:

• Systematic review and random-effects meta-analysis of controlled cohort and case-control studies published from 2020 onwards.
• Conversion of adjusted effect estimates to logarithmic scale for pooling.
• Descriptive analysis of published case reports for clinicopathological patterns.

Main Results:

• Prior TB was consistently associated with an increased risk of subsequent lung cancer (LC).
• A statistically significant positive association was demonstrated, with moderate heterogeneity.
• Case reports showed varied temporal patterns, including scar-associated carcinoma and concurrent inflammatory-malignant presentations.

Conclusions:

• Contemporary evidence supports an association between prior TB and increased lung malignancy risk.
• Limited modern longitudinal studies specifically address TB as an independent risk factor.
• A significant research gap exists, necessitating prospective studies to clarify causality and guide surveillance.