Associations Between Prior Lung Diseases and Risk of Lung Cancer in Populations With No Smoking History: A Systematic Review and Meta-Analysis.

research_question

What is the association of TB, asthma, and chronic bronchitis (CB) with lung cancer risk among individuals who do not smoke?

在不吸烟的人群中，结核、哮喘和慢性支气管炎（CB）与肺癌风险有何关联？

study_design_and_methods

PubMed and Embase were searched from inception through July 15, 2025, for studies examining the association between TB, asthma, or CB with lung cancer risk in populations older than 18 years who never smoked.

从创建开始至2025年7月15日，通过PubMed和Embase检索了研究结核病(TB)、哮喘或慢性支气管炎(CB)与18岁以上从不吸烟人群肺癌风险关联的文献。

Summary effect estimates with 95% CIs were calculated for case-control (OR) and cohort (hazard ratio[HR]) studies using random effects models with inverse variance weighting.

使用随机效应模型和逆方差加权法，为病例对照研究(OR)和队列研究(危险比[HR])计算了总结效应估计值及其95%置信区间(CI)。

Subgroup meta-analyses and metaregressions were conducted by continent.

通过大陆进行了亚组荟萃分析和元回归分析。

Study quality was reviewed using the Newcastle-Ottawa scale; bias was evaluated using funnel plots and methods by Egger et al. RESULTS: Among 20 case-control studies, TB (16 studies) and CB (9 studies) were associated significantly with increased lung cancer risk (TB: OR, 1.76 [95% CI, 1.47-2.11; I2 = 20]; CB: OR, 1.36 [95% CI, 1.07-1.72; I2 = 0]); asthma (11 studies) was associated with increased lung cancer risk, but was not statistically significant (OR, 1.34 [95% CI, 0.94-1.91; I2 = 46]).

使用纽卡斯尔-渥太华量表评估了研究质量；使用Egger等人提出的方法和漏斗图评估了偏倚。

Among 5 cohort studies, TB (4 studies) was associated with increased lung cancer risk, but was not statistically significant (HR, 1.64 [95% CI, 0.98-2.72; I2 = 75]).

在5项队列研究中，结核病（4项研究）与肺癌风险增加有关，但统计学上不显著（HR，1.64 [95% 置信区间，0.98-2.72; I2 = 75]）。

Based on meta-regression, study continent (Asian studies vs non-Asian studies) did not explain between-study variance.

基于元回归分析，研究大洲（亚洲研究与非亚洲研究）无法解释研究间的变异。

interpretation

History of TB and CB were associated with increased lung cancer risk among populations with no smoking history.

在无吸烟史的人群中，结核病(TB)和慢性支气管炎(CB)的历史与肺癌风险增加有关。

Future studies examining these associations should analyze more diverse populations and disaggregate findings by sex, race and ethnicity, and socioeconomic status.

未来研究在检验这些关联时，应分析更多样化的人群，并按性别、种族和民族以及社会经济地位对研究结果进行细分。

clinical_trial_registration

International Prospective Register of Systematic Reviews; No.: CRD42022323851; URL: https://www.crd.york.ac.uk/prospero/.

国际前瞻性系统评价注册; 编号: CRD42022323851; 网址: https://www.crd.york.ac.uk/prospero/