Influenza Vaccination and Risk of Lung Cancer in Patients with Chronic Kidney Disease: A Nationwide, Population-Based Cohort Study

SIMPLE SUMMARY: The risk of lung cancer occurrence among patients with chronic kidney disease (CKD) is significantly higher than patients with normal renal function. Moreover, the long-term outcomes of CKD patients with lung cancer are poor. We conducted the present nationwide population based study to assess the association between the risk of lung cancer and influenza vaccination. The results showed that among CKD patients, potentially risk reduction of lung cancer was observed after influenza vaccination. In addition, the potentially protective effect of influenza vaccination on lung cancer risk reduction appeared to be dose dependent. The findings of present study provided the additional effect of influenza vaccination among patients with CKD. ABSTRACT: Chronic kidney disease (CKD) is significantly associated with lung cancer incidence. The aim of this study was to elucidate whether influenza vaccination reduces the incidence of lung cancer in patients with CKD. This cohort study enrolled patients with a record of CKD diagnosis from 2000 to 2012 in Taiwan’s National Health Insurance Research Database. Included patients were divided into vaccinated and unvaccinated groups. In total 12,985 patients with CKD were enrolled. Among these patients, 5495 were vaccinated and 7490 were unvaccinated. The risk of lung cancer was significantly lower in the influenza vaccination group after adjusting for age, sex, dialysis status, lung diseases, comorbidities, level of urbanization, and monthly income (adjusted hazard ratio (HR): 0.50, 95% confidence interval (CI; 0.38–0.65), p < 0.05). Lower risk of lung cancer was observed in both sexes, all age groups, dialysis status and co-existed lung diseases. The association between the risk of lung cancer and vaccination appeared to be dose-dependent (adjusted HRs: 0.91 (0.66–1.25), 0.49 (0.34–0.71), and 0.25 (0.17–0.38) for patients who received 1, 2 or 3, and ≥4 vaccinations during the follow-up period, respectively). In conclusion, Influenza vaccination decreased the risk of lung cancer in patients diagnosed with CKD. This potentially protective effect against lung cancer appeared to be dose dependent.