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Clin Oral Investig. 2019 Feb 28. doi: 10.1007/s00784-019-02864-6. [Epub ahead of print]

Increased risk of tuberculosis in oral cancer patients in an endemic area: a nationwide population-based study.

Teng CJ1,2,3, Huon LK4,5, Zheng YM6, Yeh CM3,7, Tsai CK6, Liu JH2,7, Chen TJ2,8, Liu CJ9,10,11, Lee YL12,13,14.

Author information

1
Division of Hematology and Oncology, Department of Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
2
School of Medicine, National Yang-Ming University, Taipei, Taiwan.
3
Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
4
Department of Otolaryngology-Head and Neck Surgery, Cathay General Hospital, Taipei, Taiwan.
5
School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.
6
Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
7
Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Rd, Sec. 2, Taipei, 11217, Taiwan.
8
Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
9
School of Medicine, National Yang-Ming University, Taipei, Taiwan. chiajenliu@gmail.com.
10
Institute of Public Health, National Yang-Ming University, Taipei, Taiwan. chiajenliu@gmail.com.
11
Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, No. 201 Shipai Rd, Sec. 2, Taipei, 11217, Taiwan. chiajenliu@gmail.com.
12
Institute of Public Health, National Yang-Ming University, Taipei, Taiwan. phs2321@gmail.com.
13
Department of Dentistry, Heping Fuyou Branch, Taipei City Hospital, No. 33 Zhonghua Rd., Sec. 2, Taipei, 100, Taiwan. phs2321@gmail.com.
14
Department of Dentistry, School of Dentistry, National Yang-Ming University, Taipei, Taiwan. phs2321@gmail.com.

Abstract

OBJECTIVES:

We investigated the incidence of tuberculosis (TB) in patients with newly diagnosed oral cancer and analyzed the risk factors for TB development and mortality in oral cancer patients.

MATERIALS AND METHODS:

We used Taiwan's National Health Insurance Database to determine the incidence of TB and to analyze the risk factors for TB in patients newly diagnosed with oral cancer. From 2000 to 2011, we identified 40,327 oral cancer patients and the same number of subjects from the general population matched for sex, age, and comorbidities at a 1:1 ratio.

RESULTS:

Compared with the matched cohort, oral cancer patients exhibited a higher risk for TB (adjusted hazard ratio (aHR) 2.36, 95% confidence interval (CI) 2.06-2.71). Age ≥ 50 (aHR 1.90, 95% CI 1.57-2.29), being male (aHR 1.98, 95% CI 1.36-2.89), having diabetes mellitus (aHR 1.31, 95% CI 1.05-1.64), alcohol use disorder (aHR 1.42, 95% CI 1.06-1.89), human immunodeficiency virus (HIV) (aHR 8.24, 95% CI 2.05-33.14), chemotherapy (aHR 1.41, 95% CI 1.15-1.72), and radiotherapy for oral cancer (aHR 1.92, 95% CI 1.57-2.36) were identified as independent risk factors for TB in oral cancer patients. Hyperlipidemia was an independent protective factor for TB in oral cancer patients.

CONCLUSION:

Old age, male sex, diabetes mellitus, alcohol use disorder, and HIV were independent risk factors for TB in patients with oral cancer.

CLINICAL RELEVANCE:

High-risk oral cancer patients should be regularly screened for TB, especially those in endemic areas.

KEYWORDS:

Epidemiology; Oral cancer; Population-based study; Tuberculosis

PMID:
30820823
DOI:
10.1007/s00784-019-02864-6

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