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Background <p>Although nontuberculous mycobacterial pulmonary disease (NTM-PD) is becoming increasingly prevalent worldwide, its associated cancer risk remains largely unknown. In this study, we aimed to determine whether patients with NTM-PD are at a higher risk of developing cancer than the general population.</p> Methods <p>In this retrospective nationwide cohort study using the National Health Insurance Service-National Health Information Database of South Korea, we identified 21,879 patients newly diagnosed with NTM-PD between 2010 and 2020, and included 218,790 age- and sex-matched control participants. Cumulative incidences of various cancer types were analyzed using competing risk analysis with all-cause mortality as a competing event, and cause-specific hazard ratios (HRs) were estimated using Cox proportional hazards models adjusted for demographic factors and baseline health checkup results.</p> Results <p>After adjustment, patients with NTM-PD showed a significantly higher risk of overall cancer than did matched controls (adjusted HR, 1.22; 95% confidence interval, 1.17–1.27; <i>P</i> &lt; .001). In the analysis according to cancer type, the following cancers showed significant changes in risk (adjusted HR [95% confidence interval]): lung cancer (2.25 [2.06–2.45]), multiple myeloma (1.74 [1.26–2.42]), ovarian cancer (1.33 [1.06–1.68]), pancreatic cancer (1.26 [1.09–1.45]), and liver cancer (1.22 [1.07–1.39]). By contrast, stomach (0.83 [0.72–0.96]) and colorectal (0.83 [0.73–0.95]) cancers showed a reduced risk. These associations remained robust across multiple sensitivity analyses.</p> Conclusions <p>Compared with the general population, patients with NTM-PD are at an increased risk of various cancers, particularly lung cancer. These findings underscore the need for increased cancer surveillance and long-term monitoring of patients with NTM-PD.</p>

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Cancer risk in patients with nontuberculous mycobacterial pulmonary disease: a nationwide population-based cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月16日

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  • Chanho Lee,
  • Hyeon Kyu Choi,
  • Hyeok-Hee Lee,
  • Young Ae Kang,
  • Eun Young Kim,
  • Hyung Woo Kim,
  • Naeun Shin,
  • Youngmok Park

摘要

Background

Although nontuberculous mycobacterial pulmonary disease (NTM-PD) is becoming increasingly prevalent worldwide, its associated cancer risk remains largely unknown. In this study, we aimed to determine whether patients with NTM-PD are at a higher risk of developing cancer than the general population.

Methods

In this retrospective nationwide cohort study using the National Health Insurance Service-National Health Information Database of South Korea, we identified 21,879 patients newly diagnosed with NTM-PD between 2010 and 2020, and included 218,790 age- and sex-matched control participants. Cumulative incidences of various cancer types were analyzed using competing risk analysis with all-cause mortality as a competing event, and cause-specific hazard ratios (HRs) were estimated using Cox proportional hazards models adjusted for demographic factors and baseline health checkup results.

Results

After adjustment, patients with NTM-PD showed a significantly higher risk of overall cancer than did matched controls (adjusted HR, 1.22; 95% confidence interval, 1.17–1.27; P < .001). In the analysis according to cancer type, the following cancers showed significant changes in risk (adjusted HR [95% confidence interval]): lung cancer (2.25 [2.06–2.45]), multiple myeloma (1.74 [1.26–2.42]), ovarian cancer (1.33 [1.06–1.68]), pancreatic cancer (1.26 [1.09–1.45]), and liver cancer (1.22 [1.07–1.39]). By contrast, stomach (0.83 [0.72–0.96]) and colorectal (0.83 [0.73–0.95]) cancers showed a reduced risk. These associations remained robust across multiple sensitivity analyses.

Conclusions

Compared with the general population, patients with NTM-PD are at an increased risk of various cancers, particularly lung cancer. These findings underscore the need for increased cancer surveillance and long-term monitoring of patients with NTM-PD.