Concomitant Pulmonary Tuberculosis and Lung Cancer

Background The coexistence of pulmonary tuberculosis (TB) and primary lung cancer (LC) is rare but clinically significant, particularly in regions with a high prevalence of TB. This association presents major diagnostic and therapeutic challenges, influencing patient prognosis. Methods A retrospective case-control study was conducted over 4 years, including 14 patients with TB/LC and 28 controls with LC only. Patients were matched by age, sex, and comorbidities. Data collected were compared between the two groups. Logistic regression analysis identified factors associated with this coexistence and prognosis. Results The annual incidence of TB/LC coexistence was 3.5 cases per year, with a prevalence of 1% among new tuberculosis cases. The median survival of TB/LC patients was 8 months (4.75–11 months), compared to 24 months (19–27 months) for controls ( P < 0.001). Diagnostic delays were significant, with a median delay of 4.5 months (2–6 months) for TB/LC patients compared to 1 month (0.8–1.7 months) for controls. Therapeutic initiation was delayed, with a median delay of 60 days (45–60 days) in TB/LC patients versus 25 days (21–30 days) for controls, whereas the median hospital stay was 26.71 ± 4.48 days compared to 17.32 ± 5.39 days for controls. Analysis revealed that chest pain (OR, 4.5; 95% CI, 1.12–18.13), dyspnea (OR, 20.83; 95% CI, 3.93–110.33), fever (OR, 15; 95% CI, 2.96–75.91), night sweats (OR, 7.5; 95% CI, 1.77–31.68), anorexia (OR, 6.92; 95% CI, 1.3–36.82), and bilateral radiological lesions (OR, 6.8; 95% CI, 1.03−104.72) were strongly associated with TB/LC coexistence. Poor prognostic factors included elevated CRP >100 mg/L (OR, 10.8; 95% CI, 1.07–108.62) and the presence of drug interactions (OR, 8.33; 95% CI, 1.7–40.91). Conclusions TB/LC coexistence is associated with a poor prognosis due to diagnostic and therapeutic delays. An integrated multidisciplinary approach is essential to improve prognosis.