Risk factors for early-onset lung cancer in Korea: analysis of a nationally representative population-based cohort
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OBJECTIVES: We examined the associations of socioeconomic factors, health behaviors, and comorbidities with early-onset lung cancer. METHODS: The study included 6,794,287 individuals aged 20-39 years who participated in a Korean national health check-up program from 2009 to 2012. During the follow-up period, 4,684 participants developed lung cancer. Multivariable Cox regression analysis was used to estimate the independent associations of potential risk factors with incident lung cancer. RESULTS: Older age (multivariable hazard ratio [mHR], 1.13; 95% confidence interval [CI], 1.12 to 1.14) and female sex (mHR, 1.62; 95% CI, 1.49 to 1.75) were associated with increased lung cancer risk. Current smoking was also associated with elevated risk (<10 pack-years: mHR, 1.12; 95% CI, 1.01 to 1.24; ≥10 pack-years: mHR, 1.30; 95% CI, 1.18 to 1.45), but past smoking was not. Although mild alcohol consumption (<10 g/day) was associated with lower lung cancer risk (mHR, 0.92; 95% CI, 0.86 to 0.99), heavier alcohol consumption (≥10 g/day) was not. Higher income (highest vs. lowest quartile: mHR, 0.86; 95% CI, 0.78 to 0.94), physical activity for at least 1,500 metabolic equivalent of task-min/wk (vs. non-exercisers: mHR, 0.83; 95% CI, 0.69 to 0.99) and obesity (vs. normal weight: mHR, 0.89; 95% CI, 0.83 to 0.96) were associated with lower lung cancer risk, whereas metabolic syndrome was associated with increased risk (mHR, 1.13; 95% CI, 1.03 to 1.24). CONCLUSIONS: In young adults, age, female sex, smoking, and metabolic syndrome were risk factors for early-onset lung cancer, while high income, physical activity, and obesity displayed protective effects.
Abstract
OBJECTIVES: We examined the associations of socioeconomic factors, health behaviors, and comorbidities with early-onset lung cancer. METHODS: The study included 6,794,287 individuals aged 20-39 years who participated in a Korean national health check-up program from 2009 to 2012. During the follow-up period, 4,684 participants developed lung cancer. Multivariable Cox regression analysis was used to estimate the independent associations of potential risk factors with incident lung cancer. RESULTS: Older age (multivariable hazard ratio [mHR], 1.13; 95% confidence interval [CI], 1.12 to 1.14) and female sex (mHR, 1.62; 95% CI, 1.49 to 1.75) were associated with increased lung cancer risk. Current smoking was also associated with elevated risk (<10 pack-years: mHR, 1.12; 95% CI, 1.01 to 1.24; ≥10 pack-years: mHR, 1.30; 95% CI, 1.18 to 1.45), but past smoking was not. Although mild alcohol consumption (<10 g/day) was associated with lower lung cancer risk (mHR, 0.92; 95% CI, 0.86 to 0.99), heavier alcohol consumption (≥10 g/day) was not. Higher income (highest vs. lowest quartile: mHR, 0.86; 95% CI, 0.78 to 0.94), physical activity for at least 1,500 metabolic equivalent of task-min/wk (vs. non-exercisers: mHR, 0.83; 95% CI, 0.69 to 0.99) and obesity (vs. normal weight: mHR, 0.89; 95% CI, 0.83 to 0.96) were associated with lower lung cancer risk, whereas metabolic syndrome was associated with increased risk (mHR, 1.13; 95% CI, 1.03 to 1.24). CONCLUSIONS: In young adults, age, female sex, smoking, and metabolic syndrome were risk factors for early-onset lung cancer, while high income, physical activity, and obesity displayed protective effects.
참고문헌 (49)
- Siegel RL, "Cancer statistics, 2023", CA Cancer J Clin, 73, pp.17~48 (2023)
- 강미주, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2020", Cancer Research and Treatment, 55(2), pp.385~399 (2023), 대한암학회[DOI]
- Tammemagi CM, "Lung cancer risk prediction : prostate, lung, colorectal and ovarian cancer screening trial models and validation", J Natl Cancer Inst, 103, pp.1058~1068 (2011)
- Hoggart C, "A risk model for lung cancer incidence", Cancer Prev Res(Phila), 5, pp.834~846 (2012)
- Marcus MW, "LLPi: Liverpool lung project risk prediction model for lung cancer incidence", Cancer Prev Res(Phila), 8, pp.570~575 (2015)
- Thomas A, "Trends and characteristics of young non-small cell lung cancer patients in the United States", Front Oncol, 5, pp.113~ (2015)
- Subramanian J, "Distinctive characteristics of non-small cell lung cancer(NSCLC)in the young : a surveillance, epidemiology, and end results(SEER)analysis", J Thorac Oncol, 5, pp.23~28 (2010)
- Yeo Y, "Individual 5-year lung cancer risk prediction model in Korea using a nationwide representative database", Cancers(Basel), 13, pp.3496~ (2021)
- Ilar A, "Occupational exposure to diesel motor exhaust and risk of lung cancer by histological subtype : a population-based case-control study in Swedish men", Eur J Epidemiol, 32, pp.711~719 (2017)
- Raaschou-Nielsen O, "Air pollution and lung cancer incidence in 17 European cohorts : prospective analyses from the European Study of Cohorts for Air Pollution Effects(ESCAPE)", Lancet Oncol, 14, pp.813~822 (2013)
- Radzikowska E, "Lung cancer in patients under 50 years old", Lung Cancer, 33, pp.203~211 (2001)
- Sekine I, "Young lung cancer patients in Japan : different characteristics between the sexes", Ann Thorac Surg, 67, pp.1451~1455 (1999)
- Shi J, "Epidemiology and prognosis in young lung cancer patients aged under 45 years old in northern China", Sci Rep, 11, pp.6817~ (2021)
- Jemal A, "Higher lung cancer incidence in young women than young men in the United States", N Engl J Med, 378, pp.1999~2009 (2018)
- Liu B, "Lung cancer in young adults aged 35 years or younger : a full-scale analysis and review", J Cancer, 10, pp.3553~3559 (2019)
- Kreuzer M, "Risk factors for lung cancer in young adults", Am J Epidemiol, 147, pp.1028~1037 (1998)
- Skarin AT, "Lung cancer in patients under age 40", Lung Cancer, 32, pp.255~264 (2001)
- Seong SC, "Data resource profile : the National Health Information Database of the National Health Insurance Service in South Korea", Int J Epidemiol, 46, pp.799~ (2017)
- Shin DW, "National General Health Screening Program in Korea : history, current status, and future direction", Precis Futur Med, 6, pp.9~31 (2022)
- 양민수, "Validation of Cancer Diagnosis Based on the National Health Insurance Service Database versus the National Cancer Registry Database in Korea", Cancer Research and Treatment, 54(2), pp.352~361 (2022), 대한암학회[DOI]
- Yoo JE, "Association of the frequency and quantity of alcohol consumption with gastrointestinal cancer", JAMA Netw Open, 4, pp.e2120382~ (2021)
- Kang J, "The associations of aspirin, statins, and metformin with lung cancer risk and related mortality : a time-dependent analysis of population-based nationally representative data", J Thorac Oncol, 16, pp.76~88 (2021)
- Anuurad E, "The new BMI criteria for asians by the regional office for the western pacific region of WHO are suitable for screening of overweight to prevent metabolic syndrome in elder Japanese workers", J Occup Health, 45, pp.335~343 (2003)
- Sin S, "Metabolic syndrome and risk of lung cancer : an analysis of Korean National Health Insurance Corporation Database", J Clin Endocrinol Metab, 105, pp.dgaa596~ (2020)
- Jeong SW, "Mortality reduction with physical activity in patients with and without cardiovascular disease", Eur Heart J, 40, pp.3547~3555 (2019)
- Alberti KG, "Harmonizing the metabolic syndrome : a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity", Circulation, 120, pp.1640~1645 (2009)
- Lee S, "Cut-off points of waist circumference for defining abdominal obesity in the Korean population", Korean J Obes, 15, pp.1~9 (2006)
- Winkler Wille MM, "Predictive accuracy of the PanCan lung cancer risk prediction model-external validation based on CT from the Danish lung cancer screening trial", Eur Radiol, 25, pp.3093~3099 (2015)
- de Torres JP, "Lung cancer in patients with chronic obstructive pulmonary disease--incidence and predicting factors", Am J Respir Crit Care Med, 184, pp.913~919 (2011)
- Sidorchuk A, "Socioeconomic differences in lung cancer incidence : a systematic review and meta-analysis", Cancer Causes Control, 20, pp.459~471 (2009)
- Hiscock R, "Socioeconomic status and smoking : a review", Ann N Y Acad Sci, 1248, pp.107~123 (2012)
- Potter JD, "Diet and cancer : possible explanations for the higher risk of cancer in the poor", IARC Sci Publ, pp.265~283 (1997)
- Hecht SS, "Cigarette smoking and lung cancer : chemical mechanisms and approaches to prevention", Lancet Oncol, 3, pp.461~469 (2002)
- Peto R, "Smoking, smoking cessation, and lung cancer in the UK since 1950 : combination of national statistics with two case-control studies", BMJ, 321, pp.323~329 (2000)
- Liang W, "Reduction in alcohol consumption and health status", Addiction, 106, pp.75~81 (2011)
- Alfano CM, "Physical activity in relation to all-site and lung cancer incidence and mortality in current and former smokers", Cancer Epidemiol Biomarkers Prev, 13, pp.2233~2241 (2004)
- Wang A, "Physical activity and sedentary behavior in relation to lung cancer incidence and mortality in older women : the women’s health initiative", Int J Cancer, 139, pp.2178~2192 (2016)
- Lee IM, "Physical activity and risk of lung cancer", Int J Epidemiol, 28, pp.620~625 (1999)
- Pedersen BK, "NK cell response to physical activity : possible mechanisms of action", Med Sci Sports Exerc, 26, pp.140~146 (1994)
- Morrow JD, "Increase in circulating products of lipid peroxidation(F2-isoprostanes)in smokers. Smoking as a cause of oxidative damage", N Engl J Med, 332, pp.1198~1203 (1995)
- Yu D, "Overall and central obesity and risk of lung cancer : a pooled analysis", J Natl Cancer Inst, 110, pp.831~842 (2018)
- Yang Y, "Obesity and incidence of lung cancer : a meta-analysis", Int J Cancer, 132, pp.1162~1169 (2013)
- Loft S, "Oxidative DNA damage estimated by 8-hydroxydeoxyguanosine excretion in humans : influence of smoking, gender and body mass index", Carcinogenesis, 13, pp.2241~2247 (1992)
- Mizoue T, "Leanness, smoking, and enhanced oxidative DNA damage", Cancer Epidemiol Biomarkers Prev, 15, pp.582~585 (2006)
- Brennan P, "Obesity and cancer : Mendelian randomization approach utilizing the FTO genotype", Int J Epidemiol, 38, pp.971~975 (2009)
- Kim WY, "Elevated epithelial insulin-like growth factor expression is a risk factor for lung cancer development", Cancer Res, 69, pp.7439~7448 (2009)
- Mendonça FM, "Metabolic syndrome and risk of cancer: which link?", Metabolism, 64, pp.182~189 (2015)
- Lindgren A, "Blood pressure, smoking, and the incidence of lung cancer in hypertensive men in North Karelia, Finland", Am J Epidemiol, 158, pp.442~447 (2003)
- Bangalore S, "Antihypertensive drugs and risk of cancer : network meta-analyses and trial sequential analyses of 324, 168 participants from randomised trials", Lancet Oncol, 12, pp.65~82 (2011)