COPD O-029 : Impact of Pulmonary Tuberculosis on the Incidence of Lung Cancer among Patients with Chronic Obstructive Pulmonary Disease

Background While history of pulmonary tuberculosis (PTB) is risk factor for developing both COPD and lung cancer, it remains unclear whether history of PTB affects the development of lung cancer in COPD patients. This study aimed to evaluate the impact of history of PTB on lung cancer development in COPD patients based on smoking status. Methods This cohort study included a nationwide representative sample of 13,165 Korean men and women with COPD, aged between 50-84 years followed-up to 13 years (January 1st, 2003 to December 31st, 2015). History of PTB was based on the Results of chest radiography and incident lung cancer was identified from hospitalization and outpatient visit claims (ICD-10 diagnosis codes C33 or C34). Results During 97,908 person-years (PY) of follow-up (median follow-up 7.3 years), we observed 430 incident cases of lung cancer in COPD subjects without a history of PTB (incidence rate 524 per 100,000 PY) and 148 cases in COPD subjects with a history of PTB (incidence rate 931 per 100,000 PY). Compared to COPD subjects without a history of PTB, the fully adjusted hazard ratios (95% confidence interval) for lung cancer in those with a history of PTB was 1.24 (1.03, 1.50). The impact of history of PTB on lung cancer development was more evident in never smokers (Figure). Conclusions History of PTB was associated with an increased risk of development of lung cancer among COPD patients in our country with an intermediate TB burden. COPD patients with history of PTB, especially who are never smokers, should undergo periodical screening or assessment for the development of lung cancer.