Publications (2)5.46 Total impact
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Article: Tuberculosis is associated with increased lung cancer mortality.
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ABSTRACT: Elderly persons living in the community in Hong Kong. To examine the association between tuberculosis (TB) and lung cancer. Elderly clients enrolled in a health programme from 2000 to 2003 were retrospectively cross-matched with the territory-wide TB notification registry for TB before enrolment. The cohort was followed up prospectively through linkage with the territory-wide death registry for cause of death until 31 December 2011. All subjects with suspected malignancy or recent weight loss (≥5%) at enrolment and deaths within the first 2 years of follow-up were excluded. Of the 61 239 subjects included, 516 had TB before enrolment. After 490 258 person-years of follow-up, respectively 1344, 910 and 2003 deaths were caused by lung cancer, other tobacco-related malignancies and non-tobacco-related malignancies. TB before enrolment was associated with death due to lung cancer (Mantel-Haenszel weighted relative risk 2.61, 95%CI 1.82-3.74, P < 0.001) but not other malignancies after stratification by sex. TB remained an independent predictor of lung cancer death (adjusted hazard ratio 2.01, 95%CI 1.40-2.90; P < 0.001), after adjustment for multiple potential confounders. TB was independently associated with subsequent mortality due to lung cancer. This finding calls for intensification of tobacco control and better targeting of lung cancer screening in high TB burden areas.The international journal of tuberculosis and lung disease: the official journal of the International Union against Tuberculosis and Lung Disease 05/2013; 17(5):687-92. · 2.73 Impact Factor -
Article: Obstructive lung disease does not increase lung cancer mortality among female never-smokers in Hong Kong.
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ABSTRACT: High lung cancer mortality is observed among female never-smokers in Hong Kong. To examine the relationship between obstructive lung disease (chronic obstructive pulmonary disease and/or asthma) and lung cancer mortality by sex and smoking status. A cohort of elderly clients (aged ≥65 years) in a health maintenance programme were followed prospectively through linkage with the territory-wide death registry for causes of death, using identity card number as the unique identifier. After 516,055 person-years of follow-up, respectively 1297, 872 and 1908 deaths were caused by lung cancer, other tobacco-related malignancies and non-tobacco-related malignancies. In the overall analysis, obstructive lung disease was independently associated with mortality due to lung cancer (aHR 1.86, P < 0.001) after adjustment for potential confounders. However, no association was detected among female never-smokers (HR 0.97, P = 0.909), in sharp contrast with female ever-smokers, male never-smokers and male ever-smokers (HR 1.98, 2.34 and 2.09, respectively, P from 0.047 to <0.001). Consistent results were observed after exclusion of all deaths in the initial 3 years. Obstructive lung disease exerted differential effects on lung cancer mortality across different sex and smoking subgroups in this Asian population, with a conspicuous absence of effect among female never-smokers.The international journal of tuberculosis and lung disease: the official journal of the International Union against Tuberculosis and Lung Disease 02/2012; 16(4):546-52. · 2.73 Impact Factor
