Risk of active tuberculosis in migrants diagnosed with cancer: a retrospective cohort study in British Columbia, Canada

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

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.

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