Published: 2 March 2021

Authors: Divjot S Kumar, Lisa A Ronald, Kamila Romanowski, Caren Rose, Hennady P Shulha, Victoria J Cook, James C Johnston

Source: This abstract has been sourced from NZ Respiratory Research Review Issue 187


    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.

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