BCG vaccine tied to lower risk for lung cancer in Native populations

  • Usher NT & al.
  • JAMA Netw Open
  • 4 Sep 2019

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • American Indian and Alaska Native children who received the BCG tuberculosis (TB) vaccine were 62% less likely to develop lung cancer as adults.
  • No association was observed with other types of cancer.

Why this matters

  • These findings contradict earlier studies suggesting increased rates of leukemia and lymphoma.

Study design

  • Post hoc analysis of a randomized, multistate clinical trial.
  • 3287 American Indian and Alaska Native children from 9 tribes received BCG vaccine (n=1540) or a placebo (n=1423) between 1935 and 1938 at a median age of 8 years.
  • 60-year follow-up.
  • Funding: Indian Health Service and others.

Key results

  • Overall incidence of cancer was not significantly different between groups (HR, 0.82; 95% CI, 0.66-1.02).
  • After multivariable analysis, lung cancer incidence was significantly lower in the vaccine group (aHR, 0.38; P=.005).
  • Lung cancer mortality was significantly lower in the vaccine group (HR, 0.32; 95% CI, 0.15-0.68).
  • Prior TB was not significantly associated with lung cancer (HR, 0.66; 95% CI, 0.23-1.90).
  • No difference between groups in incidence of any other type of cancer.
  • Lung cancer rates were reduced in all 5 states and all 9 tribes.

Limitations

  • Retrospective design.

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