Coexisting Lung Cancer and Pulmonary Tuberculosis - A Comprehensive Review From Incidence to Management

Sep 23, 2026

Uploaded by Jacob

Review examines how tuberculosis (TB) and lung cancer (LC) influence each other from epidemiology to clinical care. It highlights rising co-occurrence in modern cancer therapy contexts, where immunotherapy and longer survival affect infection risk. Findings show LC patients with prior TB have higher 3-year mortality risk, and TB can promote tumor development via chronic inflammation, immune disruption, and DNA damage. Conversely, cancer and treatment-related immune dysfunction may increase TB susceptibility. Effective management strategies are essential to improve outcomes and quality of life.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages14

Reading Time35 min

AccessFree to download

Abstract

Background

Aim

Results

Conclusion

Introduction

Global burden of tuberculosis

Global burden of lung cancer

Bidirectional relationship and clinical challenge

Cancer Reports REVIEW OPEN ACCESS Coexisting Lung Cancer and Pulmonary Tuberculosis: A Comprehensive Review From Incidence to Management Wendi Zhou1,2 | Hongxu Lu1 | Jiamin Lin1 | Jialou Zhu1 | Jizhen Liang3 | Yalin Xie1 | Jinxing Hu1 | Ning Su1 1State Key Laboratory of Respiratory Disease, Guangzhou Key Laboratory of Tuberculosis Research, Guangzhou Chest Hospital, Institute of Tuberculosis, Guangzhou Medical University, Guangzhou, P. R. China | 2Department of Children's Psychological and Rehabilitation, Shen Zhen Maternity and Child Health Hospital, Southern Medical University, Shenzhen, P. R. China | 3Department of Oncology, Guangzhou Red Cross Hospital, Guangzhou, P. R. China Correspondence: Jinxing Hu ([hujinxing@gzhmu.edu.cn](hujinxing@gzhmu.edu.cn)) | Ning Su ([snxkyy@gzhmu.edu.cn](snxkyy@gzhmu.edu.cn)) Received: 28 August 2024 | Revised: 30 January 2025 | Accepted: 11 April 2025 Funding: This work was supported by the Guangzhou Municipal Science and Technology Project, 2023A03J0529, 2023A03J0534, 2023A03J0992 . Keywords: chronic inflammation | clinical management | DNA damage | immune checkpoint inhibitors | lung cancer | tuberculosis ABSTRACT Background: Globally, infections account for 10% of new cancer cases, and cancer can compromise the immune system, increasing the risk of infections. With advances in cancer treatment, widespread use of immunotherapy, and prolonged survival of cancer patients, the coexistence of tuberculosis (TB) and cancer is becoming increasingly common in clinical settings. Aim: This review aims to explore the interaction between tuberculosis (TB) and tumors, particularly lung cancer (LC), and to identify appropriate clinical management approaches. Results: LC patients with a history ofTB have higher adjusted risk ratios for both all-cause and cancer-specific 3-year mortality compared to those without a history of TB. TB may elevate the risk of developing tumors through mechanisms such as chronic inflammation, altered immune responses, and DNA damage. Conversely, cancer patients, whether due to the disease itself or immune dysfunction caused by anti-tumor treatments, may be more susceptible to TB. The coexistence ofTB and tumors presents significant challenges in clinical management, making the development of treatment strategies and quality-of-life improvements crucial. Conclusion: There is a close relationship between TB and cancer, with TB potentially serving as a risk factor for cancer, and cancer influencing susceptibility to TB. Effective clinical management is essential to enhance treatment strategies and improve the quality of life for patients with both TB and cancer. 1 | Introduction Tuberculosis (TB), a chronic infectious disease caused by Mycobacterium tuberculosis (Mtb), is the second deadliest infectious disease after COVID-19. China ranks third among the 30 high-burden countries, accounting for 7.4% of the global TB cases [1]. An estimated quarter of the world's population is infected with Mtb, with approximately 5%–10% of TB infections progressing to active TB [2]. TB remains a major global health issue, especially multi-drug resistant tuberculosis (MDR-TB), with treatment success rates typically below 60%. The risk of potential TB infection due to MDR strains is twice as high in children as that in adults [3, 4]. China has the second highest burden of MDR-TB, presenting an urgent challenge in controlling its spread [5, 6]. | Wendi Zhou and Hongxu Lu contributed equally to this work. | | --- | | This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
© 2025 The Author(s). Cancer Reports published by Wiley Periodicals LLC. | Cancer Reports, 2025; 8:e70213 1 of 14 [https://doi.org/10.1002/cnr2.70213](https://doi.org/10.1002/cnr2.70213) In 2020, cancer was the second leading cause of death glob

FAQs

Why is TB and lung cancer coexistence becoming more common in clinical settings?

Advances in cancer treatment, widespread immunotherapy use, and prolonged survival increase infection vulnerability, making TB co-occurrence with cancer more frequent.

How do TB and lung cancer affect each other according to the review?

TB may elevate tumor risk through chronic inflammation, altered immune responses, and DNA damage, while cancer—through disease effects or immune dysfunction from anti-tumor treatments—may increase susceptibility to TB.

What clinical management priority does the review emphasize for patients with both diseases?

Developing treatment strategies and improving quality of life are crucial, since coexistence creates significant challenges requiring effective clinical management.

Sep 23, 2026

Uploaded by Jacob