WCLC 2025 - Posters & ePosters-P3.01.45 Restrictive Lung Function and Smoking Increase Lung Cancer Risk in Tuberculosis Survivors: A Cohort Study

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This cohort study investigated lung cancer risk factors among 9,734 tuberculosis (TB) survivors to clarify how lung function impairments and smoking influence malignancy development. TB is known to increase lung cancer risk through chronic inflammation and fibrosis, but detailed risk profiles in TB survivors, particularly younger and healthier populations, were previously unclear.<br /><br />Participants were drawn from a large Korean health screening cohort conducted between 2002 and 2021. TB history and lung cancer diagnoses were identified via questionnaires and national cancer registry linkage, respectively. Lung function was assessed by spirometry and categorized as normal, restrictive, or obstructive (with restrictive defined as non-obstructive low forced vital capacity). Baseline data revealed that lung cancer cases (22 diagnosed) tended to be older and more frequently heavy smokers and drinkers, with a higher prevalence of restrictive or obstructive lung patterns.<br /><br />Univariate analyses found that both restrictive (hazard ratio [HR] 2.58) and obstructive (HR 6.48) impairments, older age, heavy alcohol use, diabetes, and heavy smoking (≥20 pack-years) significantly increased lung cancer risk. In multivariate models adjusting for confounders, restrictive lung function remained a strong independent risk factor (HR 2.94), as did heavy smoking, while obstructive dysfunction lost significance. Cumulative incidence analyses demonstrated that abnormal pulmonary function substantially elevated early lung cancer development among TB survivors.<br /><br />The study emphasizes restrictive lung impairment and heavy smoking as key contributors to increased lung cancer risk post-TB infection. These findings suggest that TB survivors, especially those with restrictive lung patterns or heavy smoking histories, need diligent lung cancer screening and targeted preventive strategies to reduce morbidity and mortality. Overall, the research underscores the importance of monitoring pulmonary function and lifestyle factors to improve early lung cancer detection in this vulnerable population.

Asset Subtitle

Yun-Gyoo Lee

Meta Tag

Speaker Yun-Gyoo Lee

Topic Risk Factors, Risk Reduction & Tobacco Control

Keywords

lung cancer risk

tuberculosis survivors

lung function impairment

restrictive lung pattern

obstructive lung pattern

heavy smoking

cohort study

spirometry

cancer screening

Korean health cohort