ArticleThe Korean journal of internal medicine2026
Restrictive lung function and smoking increase lung cancer risk in tuberculosis survivors: a cohort study.
Article in The Korean journal of internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Beyond airway obstruction: restrictive lung physiology as an independent risk factor for lung cancer in tuberculosis survivors.The Korean journal of internal medicine · 2026Article
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Abstract
BACKGROUND/
aimsIndividuals with prior tuberculosis (TB) infection represent a high-risk group for lung cancer due to chronic pulmonary damage. Although associations between TB and lung cancer have been established, this study aimed to explore specific risk factors of lung cancer development in TB survivors.
methodsData from 9,734 TB survivors within the Kangbuk Samsung Cohort Study (2011-2021) were analyzed. Pulmonary function was assessed by spirometry and classified as normal, restrictive, or obstructive. Multivariable Cox proportional hazard models were used to evaluate the relationships among lung function, smoking, alcohol consumption, comorbidities, and lung cancer incidence.
resultsParticipants were mostly male (65.4%), with an average age of 41.2 years. Over a median follow-up of 12.3 years, 22 lung cancer cases were identified. Univariate analysis revealed significant associations with restrictive (hazard ratio [HR] 2.58, 95% CI 1.00-6.65; p = 0.050) and obstructive (HR 6.48, 95% CI 2.05-20.43; p < 0.001) lung function, age (HR 2.35 per 5-year; p < 0.001), heavy smoking (HR 6.62; p < 0.001), alcohol (HR 3.05; p = 0.019), and diabetes (HR 6.40; p = 0.003). In multivariable models, restrictive lung function (HR 2.94, 95% CI 1.00-8.65; p = 0.050), age (HR 1.73; p < 0.001), and heavy smoking (HR 4.09; p = 0.010) persisted as independent risk factors. Obstructive lung function initially showed a strong association but was not significant after adjusting for covariates, indicating confounding.
conclusionRestrictive lung function, likely indicative of post-TB fibrotic changes, heavy smoking, and older age significantly predict lung cancer development in TB survivors. These results highlight the need for surveillance using spirometry for TB survivors.
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