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Increased Lung Cancer Risk Among Patients with Pneumococcal Pneumonia: A Nationwide Population-Based Cohort Study

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Abstract

Background

The possible effects of pneumonia on subsequent lung cancer have been reported, but no relevant publications have focused on the association between pneumococcal pneumonia and lung cancer. The purpose of this study was to perform a nationwide population-based cohort study to investigate the risk of lung cancer after pneumococcus infection.

Methods

This nationwide population-based cohort study was based on data obtained from the Taiwan National Health Insurance Database. In total, 22,034 pneumococcal pneumonia patients and 88,136 controls, matched for age and sex, were recruited for the study from 1997 to 2010.

Results

The incidence rate of lung cancer (28.2 per 1,000 person-years) was significantly higher in pneumococcal pneumonia patients than in controls (8.7 per 1,000 person-years; incidence rate ratio, 3.25; 95 % confidence interval, 3.09–3.42; p < 0.001). Cox proportional hazards regression analysis showed a hazard ratio of 4.24 (95 % confidence interval, 3.96–4.55) for the pneumococcal pneumonia cohort after adjustment for age, gender, and comorbidities.

Conclusions

Pneumococcal pneumonia is associated with an increased risk of lung cancer. Thus, physicians should remain aware of this association when assessing patients with pneumococcal pneumonia.

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Acknowledgments

The study was supported by grants from the study hospital (DMR-101-061 and DMR-100-076); Taiwan Department of Health Clinical Trial and Research Center and for Excellence (DOH102-TD-B-111-004), Taiwan Department of Health Cancer Research Center for Excellence (DOH102-TD-C-111-005); and International Research-Intensive Centers of Excellence in Taiwan (I-RiCE) (NSC101-2911-I-002-303).

Conflict of interest

All authors declare that they have no conflicts of interest.

Author information

Authors and Affiliations

  1. Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Te-Yu Lin & Jung-Chung Lin

  2. Department of Radiation Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan

    Wen-Yen Huang

  3. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan

    Wen-Yen Huang

  4. Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan

    Cheng-Li Lin & Fung-Chang Sung

  5. Department of Public Health, China Medical University, Taichung, Taiwan

    Cheng-Li Lin & Fung-Chang Sung

  6. Department of Nuclear Medicine and PET Center, China Medical University Hospital, No. 2, Yuh-Der Road, Taichung, 404, Taiwan

    Chia-Hung Kao

  7. Department of Internal Medicine and Family Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, No. 539, Zhongxiao Rd., Chiayi, 600, Taiwan

    Jun-Jun Yeh

  8. Chia Nan University of Pharmacy and Science, Tainan, Taiwan

    Jun-Jun Yeh

  9. Meiho University, Pingtung, Taiwan

    Jun-Jun Yeh

  10. Graduate Institute of Clinical Medicine Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 404, Taiwan

    Chia-Hung Kao

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  1. Te-Yu Lin
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  2. Wen-Yen Huang
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  3. Jung-Chung Lin
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  4. Cheng-Li Lin
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  5. Fung-Chang Sung
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  6. Chia-Hung Kao
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  7. Jun-Jun Yeh
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Corresponding authors

Correspondence to Chia-Hung Kao or Jun-Jun Yeh.

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Lin, TY., Huang, WY., Lin, JC. et al. Increased Lung Cancer Risk Among Patients with Pneumococcal Pneumonia: A Nationwide Population-Based Cohort Study. Lung 192, 159–165 (2014). https://doi.org/10.1007/s00408-013-9523-z

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  • DOI: https://doi.org/10.1007/s00408-013-9523-z

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