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KMID : 0338420200350030692
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Korean Journal of Internal Medicine
2020 Volume.35 No. 3 p.692 ~ p.702
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Risk factors for primary lung cancer among never-smoking women in South Korea: a retrospective nationwide population-based cohort study
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Ko Yoon-Ho
Kim Seung-Joon
Kim Wan-Seop
Park Chan-Kwon
Park Cheol-Kyu
Suh Yang-Gun
Eom Jung-Seop
Cho Suk-Ki
Hur Jae-Young
Hwang Sung-Ho
Myong Jun-Pyo
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Abstract
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Background/Aims: We performed a large-scale, retrospective, nationwide, cohort study to investigate the risk factors for lung cancer among never-smoking Korean females.
Methods: The study data were collected from a general health examination and questionnaire survey of eligible populations conducted between January 1, 2003 and December 31, 2004; the data were acquired from the tailored big data distribution service of the National Health Insurance Service. After a 1-year clearance period, 5,860,922 of 6,318,878 never-smoking female participants with no previous history of lung cancer were investigated. After a median follow-up of 11.4 years, 43,473 (0.74%) participants were defined as “newly diagnosed lung cancer”.
Results: After adjusting for all variables at baseline, the variables older age, lower body mass index (BMI), less exercise, frequent alcohol drinking, meat-based diet, rural residence, and previous history of cancer were associated with a higher incidence of lung cancer. Low BMI (< 18.5 kg/m2: hazard ratio [HR], 1.33; 95% confidence interval [CI], 1.27 to 1.40) was a significant independent risk factor; as BMI decreased, HR increased. Negative associations between BMI and lung-cancer development were also observed after controlling for age (p for trend < 0.001). Drinking alcohol one to two times a week (HR, 1.25; 95% CI, 1.21 to 1.28) and eating a meat-based diet (HR, 1.08; 95% CI, 1.01 to 1.15) were associated with lung-cancer incidence.
Conclusions: Modifiable baseline characteristics, such as BMI, exercise, alcohol consumption, and diet, are risk factors for lung-cancer development among never- smoking females. Thus, lifestyle modifications may help prevent lung cancer.
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KEYWORD
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Lung neoplasm, Never-smoking women, Risk factor, Cohort studies
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