Division of Oncology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Cancer Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Korean J Intern Med. 2020 May;35(3):692-702. doi: 10.3904/kjim.2019.283. Epub 2020 Feb 19.
BACKGROUND/AIMS: We performed a large-scale, retrospective, nationwide, cohort study to investigate the risk factors for lung cancer among never-smoking Korean females.
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".
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.
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.
背景/目的：我们进行了一项大规模、回顾性、全国性的队列研究，旨在调查从不吸烟的韩国女性患肺癌的风险因素。
研究数据来自于 2003 年 1 月 1 日至 2004 年 12 月 31 日期间进行的一项适合人群的常规健康检查和问卷调查；数据来自国民健康保险服务的定制大数据分配服务。经过 1 年的清除期，对 6318878 名从不吸烟且无肺癌既往史的女性参与者中的 5860922 人进行了调查。中位随访 11.4 年后，43473 名（0.74%）参与者被诊断为“新诊断肺癌”。
在调整了所有基线变量后，年龄较大、体重指数（BMI）较低、运动较少、频繁饮酒、以肉类为主的饮食、农村居住和癌症既往史与肺癌发病率升高相关。低 BMI（<18.5kg/m2：风险比[HR]，1.33；95%置信区间[CI]，1.27 至 1.40）是一个显著的独立危险因素；随着 BMI 降低，HR 增加。在控制年龄因素后（趋势 P 值<0.001），也观察到 BMI 与肺癌发展之间存在负相关。每周饮酒 1-2 次（HR，1.25；95%CI，1.21 至 1.28）和以肉类为主的饮食（HR，1.08；95%CI，1.01 至 1.15）与肺癌发病率相关。
可改变的基线特征，如 BMI、运动、饮酒和饮食，是从不吸烟女性肺癌发生的危险因素。因此，生活方式的改变可能有助于预防肺癌。
