Table 5.
Risk of tuberculosis in patients with cancer
| Total, (n) |
TB cases, (n) | Person-years | Unadjusted | Adjusted | |||
| HR (95% CI) | P value | HR (95% CI) | P value | ||||
| Age, year | 1.02 (1.02 to 1.03) | <0.001 | 1.03 (1.02 to 1.03) | <0.001 | |||
| Sex | |||||||
| Male | 95,802 | 692 | 100 905 | 1.54 (1.33 to 1.79) | <0.001 | 1.61 (1.39 to 1.89) | <0.001 |
| Female | 45,748 | 224 | 51,616 | 1 (reference) | 1 (reference) | ||
| Health insurance type | |||||||
| National health insurance | 127,201 | 837 | 142,716 | 1 (reference) | 0.02 | 1 (reference) | |
| Medical aids* | 8495 | 73 | 8544 | 1.40 (1.10 to 1.78) | 0.01 | 1.28 (1.01 to 1.63) | 0.04 |
| Veterans | 8147 | 6 | 1262 | 0.90 (0.40 to 2.01) | 0.80 | 0.77 (0.34 to 1.72) | 0.52 |
| Type of cancer | |||||||
| NSCLC | 98,196 | 771 | 98,960 | 3.35 (1.80 to 6.25) | <0.001 | 2.43 (1.30 to 4.54) | 0.01 |
| Urothelial carcinoma | 39,268 | 135 | 49,220 | 1.27 (0.67 to 2.41) | 0.47 | 0.91 (0.48 to 1.73) | 0.76 |
| Melanoma | 4086 | 10 | 4342 | 1 (reference) | <0.001 | 1 (reference) | |
| Underlying diseases | |||||||
| Diabetes mellitus | 40,605 | 295 | 42,149 | 1.22 (1.07 to 1.41) | 0.004 | 1.07 (0.93 to 1.24) | 0.34 |
| Hypertension | 73,788 | 509 | 78,074 | 1.18 (1.04 to 1.34) | 0.01 | 0.99 (0.86 to 1.14) | 0.86 |
| Chronic lung disease | 58,054 | 491 | 59,344 | 1.77 (1.55 to 2.01) | <0.001 | 1.32 (1.15 to 1.51) | <0.001 |
| Chronic kidney disease | 6545 | 53 | 6988 | 1.28 (0.97 to 1.69) | 0.08 | 1.29 (0.97 to 1.72) | 0.08 |
| Chronic liver disease | 1583 | 15 | 1560 | 1.56 (0.94 to 2.60) | 0.88 | 1.38 (0.83 to 2.31) | 0.22 |
| Rheumatic disease | 3012 | 27 | 3159 | 1.42 (0.97 to 2.09) | 0.07 | 1.31 (0.89 to 1.93) | 0.17 |
| Predisposing factors | |||||||
| History of LTBI treatment | 1735 | 11 | 1903 | 0.97 (0.54 to 1.76) | 0.93 | 0.97 (0.54 to 1.76) | 0.92 |
| Active chemotherapy | 33,184 | 306 | 32,353 | 1.72 (1.50 to 1.98) | <0.001 | 1.45 (1.24 to 1.69) | <0.001 |
| Concomitant use of corticosteroid | 13,666 | 125 | 13,196 | 1.56 (1.29 to 1.88) | <0.001 | 1.09 (0.89 to 1.34) | 0.4 |
| Concomitant use of immunosuppressant | 1963 | 14 | 2273 | 1.03 (0.61 to 1.75) | 0.90 | 0.98 (0.58 to 1.68) | 0.95 |
| ICI treatment | 5037 | 20 | 2959 | 0.85 (0.55 to 1.33) | 0.48 | 0.73 (0.47 to 1.14) | 0.17 |
*Medical aid is a public assistance program that targets impoverished people in need of medical assistance as part of the South Korean social welfare program.
ICI, immune checkpoint inhibitor; LTBI, latent tuberculosis infection; NSCLC, non-small cell lung cancer; TB, tuberculosis.