Urinary tuberculosis is associated with the development of urothelial carcinoma but not renal cell carcinoma: A nationwide cohort study in Taiwan
Journal
British Journal of Cancer
Journal Volume
109
Journal Issue
11
Pages
2933-2940
Date Issued
2013
Author(s)
Lien Y.-C.
Lee M.-C.
Chen H.-Y.
Hsieh C.-H.
Lee C.-H.
Chao K.-M.
Abstract
Background: Obstructive uropathy and chronic urinary tract infection increase the risk of urinary tract cancer. Urinary tuberculosis (UTB) can cause chronic urinary tract inflammation, lead to obstructive uropathy, and potentially contribute to the development of urinary tract cancer. However, the association between UTB and urinary tract cancer has not been studied. Methods: This study enrolled 135 142 tuberculosis (TB) cases (male, 69%) from a nationwide health insurance research database in Taiwan and investigated the risk factors for urinary tract cancer, with emphasis on a history of UTB. The incidence of urinary tract cancer in the general population without TB was also calculated for comparison. Results: The TB patients had a mean age of 57.5 ± 19.5 years. Of the 1287 UTB and 133 855 non-UTB patients, 15 (1.2%) and 396 (0.3%) developed urothelial carcinoma, respectively (P < 0.001); and 2 (0.2%) and 96 (0.1%) developed renal cell carcinoma, respectively (P=0.240). Cox regression analysis revealed that age, male sex, end-stage renal disease, obstructive uropathy, arsenic intoxication, organ transplantation, and UTB (hazard ratio: 3.38 (2.01-5.69)) were independent risk factors for urothelial carcinoma. The hazard ratio of UTB was higher among female patients (5.26 (2.12-13.06)) than that among male patients (2.96 (1.57-5.60)). Conclusion: Urinary tuberculosis had a strong association with urothelial carcinoma, but not with renal cell carcinoma. In TB endemic areas, the urinary tract of TB patients should be scrutinised. It is also imperative that these patients be followed-up carefully in the post-treatment period, and urinalysis, ultrasonography or endoscopy should be an integral part of the follow-up. Copyright ? 2013 Cancer Research UK.
SDGs
Other Subjects
aminosalicylic acid; cycloserine; ethambutol; isoniazid; kanamycin; protionamide; pyrazinamide; quinolone derivative; rifampicin; streptomycin; terizidone; adult; arsenic poisoning; article; cancer incidence; cohort analysis; controlled study; disease association; female; follow up; hazard ratio; health insurance; human; kidney carcinoma; kidney failure; major clinical study; male; obstructive uropathy; organ transplantation; priority journal; risk factor; sex difference; Taiwan; transitional cell carcinoma; urinary tract cancer; urogenital tuberculosis; Adult; Aged; Carcinoma, Renal Cell; Carcinoma, Transitional Cell; Cohort Studies; Female; Humans; Kidney Neoplasms; Male; Middle Aged; Taiwan; Tuberculosis, Urogenital; Urinary Tract Infections; Urologic Neoplasms; Urothelium
Type
journal article