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ABSTRACT: Objectives
To describe the association between types of cancer and active tuberculosis (TB) risk in migrants. Additionally, in order to better inform latent TB infection (LTBI) screening protocols, we assessed proportion of active TB cases potentially preventable through LTBI screening and treatment in migrants with cancer.Design
Population-based, retrospective cohort study.Setting
British Columbia (BC), Canada.Participants
1 000 764 individuals who immigrated to Canada from 1985 to 2012 and established residency in BC at any point up to 2015.Primary and secondary outcome measures
Using linked health administrative databases and disease registries, data on demographics, comorbidities, cancer type, TB exposure and active TB diagnosis were extracted. Primary outcomes included: time to first active TB diagnoses, and risks of active TB following cancer diagnoses which were estimated using Cox extended hazard regression models. Potentially preventable TB was defined as active TB diagnosed >6 months postcancer diagnoses.Results
Active TB risk was increased in migrants with cancer ((HR (95% CI)) 2.5 (2.0 to 3.1)), after adjustment for age, sex, TB incidence in country of origin, immigration classification, contact status and comorbidities. Highest risk was observed with lung cancer (HR 11.2 (7.4 to 16.9)) and sarcoma (HR 8.1 (3.3 to 19.5)), followed by leukaemia (HR 5.6 (3.1 to 10.2)), lymphoma (HR 4.9 (2.7 to 8.7)) and gastrointestinal cancers (HR 2.7 (1.7 to 4.4)). The majority (65.9%) of active TB cases were diagnosed >6 months postcancer diagnosis.Conclusion
Specific cancers increase active TB risk to varying degrees in the migrant population of BC, with approximately two-thirds of active TB cases identified as potentially preventable.
SUBMITTER: Kumar DS
PROVIDER: S-EPMC7929860 | biostudies-literature | 2021 Mar
REPOSITORIES: biostudies-literature
Kumar Divjot S DS Ronald Lisa A LA Romanowski Kamila K Rose Caren C Shulha Hennady P HP Cook Victoria J VJ Johnston James C JC
BMJ open 20210302 3
<h4>Objectives</h4>To describe the association between types of cancer and active tuberculosis (TB) risk in migrants. Additionally, in order to better inform latent TB infection (LTBI) screening protocols, we assessed proportion of active TB cases potentially preventable through LTBI screening and treatment in migrants with cancer.<h4>Design</h4>Population-based, retrospective cohort study.<h4>Setting</h4>British Columbia (BC), Canada.<h4>Participants</h4>1 000 764 individuals who immigrated to ...[more]