Prevalence Lung Cancer in Former Tuberculosis Patients in Indonesia: A Systematic Review and Meta-Analysis

Abstract

Introduction: Indonesia faces a 14% increase in Tuberculosis (TB) cases, putting it 14 years behind the world's second-highest burden. This raises concerns about lung cancer risk, as studies outside Indonesia are limited.
Aim: This study aims to determine the risk of lung cancer in TB patients in Indonesia.
Methods: This systematic review with meta-analysis according to PRISMA statement with various databases. We use PEOS framework for screening and select articles to be included. We exclude articles about co-infection TB with lung cancer and misdiagnose condition. We analyze risk of bias using JBI critical appraisal tools and we used R Studio and RevMan 5.4 with random-effect model for results of data that can be generalized on a wider population.
Result: There are 3 out of 4210 articles with 1270 patients included in this study. The research came from different cities and extracted the number of patients that matched the criteria. A total of 101 (7.9%) of 1270 lung cancer patients had a history of tuberculosis. There are 8 out of 100 lung cancer patients in Indonesia had TB infection before and is dominated by the type of adenocarcinoma compared to squamous cell carcinoma (statistically not meaningful, p=0.21). This study was evaluated as heterogeneous among all inclusion studies. The risk rate of bias with the JBI was 76.6% above the risk limit of the bias agreement.
Conclusion: Patients with a history of TB need future attention and further evaluation before the occurrence of lung cancer.