A Preliminary Study on Lung Cancer Prevalence Among Patients with Tuberculosis in Lesotho

Abstract

Tuberculosis (TB) is one of the major causes of ill health associated with infection in approximately a quarter of the global population. Lesotho has been ranked among the top 30 high TB burden countries; however the prevalence of lung cancer in Lesotho has been ranked fifth among the top 5 cancers in men. This seemingly lower prevalence of lung cancer could be masked by the fact that there are a number of cancer cases among TB patients that remain undiagnosed. Therefore, a cross-sectional study was done at the 3 TB centers in Lesotho to investigate the prevalence of lung cancer among patients with TB. This study was done over a 2 months period in April and May 2019. TB patients undergoing treatment at Queen Elizabeth II hospital, St. Joseph’s Hospital and Senkatana center were invited to respond to a questionnaire, where socio-demographic data was gathered, including smoking history, occupation, method of cooking in their homes. The clinical characteristics that patients presented with were also recorded. Among patients who were aged 55 and above, 7 (6.5%) patients had smoking history of more than 30 pack-years. These patients also had family history of lung disease and had worked in the mines or factory in the past. The 7 patients also presented with more than 90% of the clinical symptoms under investigation. Of these 7 patients; 2 (6.3%) were found at Queen II, 1 (4.2%) at St. Joseph while 4 (7.7%) were found at Senkatana hospital. 48% of the study participants were aged 55 and above, while 40% smoked for more than 30 years and 56% were male. 33% of the patients had a family history of lung disease, 21% had worked in mines or factories and 11% had been exposed to prolonged indoor air pollution. Studies show that the risk of lung cancer is 1.7 - fold higher in patients infected with Tuberculosis. It is therefore recommended that lung cancer screening with low dose computed tomography (LDCT) should be done on all Lesotho patients with active TB infection, who report to have smoked for more than 30 years and are aged greater or equal to 55 years.