Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China.
Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing 210009, China.
J Public Health (Oxf). 2022 Jun 27;44(2):259-268. doi: 10.1093/pubmed/fdaa254.
Epidemiological studies have shown that some factors other than smoking may affect the risk of lung cancer in women, but the results are controversial. We conducted a meta-analysis to summarize the influencing factors of lung cancer in nonsmoking women.
Both English and Chinese databases were searched for publications from 1990 to 2020. All included studies were assessed according to the Newcastle-Ottawa Scale (NOS). The pooled odds ratios (ORs) and 95% confidence interval (CI) of influential factors were analyzed using the meta-analysis method, and the publication bias and sensitivity were analyzed.
Among the five categories, the pooled OR of cooking factors category was the highest. Among 42 influencing factors, there were frequent fried food (OR = 2.42, 95% CI: 1.73-3.38) and long menstrual cycle (0.54, 95% CI: 0.39-0.75). A positive association of history of lung diseases/family lung/all cancer with lung cancer among Asian nonsmoking women (1.82, 95% CI: 1.60-2.07). Unlike other regions, cooking factors were the main risk factor for lung cancer in Asian.
The meta-analysis suggests that cooking habits, diet, passive smoking, history of cancer and lung disease, and female reproduction are related to lung cancer in nonsmoking women. However, additional studies are warranted to extend this finding.
流行病学研究表明，除吸烟以外，还有一些因素可能会影响女性肺癌的发病风险，但结果存在争议。本研究采用荟萃分析方法，对非吸烟女性肺癌的影响因素进行总结。
检索 1990 年至 2020 年发表的英文和中文文献，根据纽卡斯尔-渥太华量表（NOS）对纳入研究进行质量评价。采用荟萃分析方法计算各影响因素的合并比值比（OR）及其 95%可信区间（CI），并进行发表偏倚和敏感性分析。
五类因素中，烹饪因素的合并 OR 值最高。42 个影响因素中，经常煎炒烹炸（OR=2.42，95%CI：1.73-3.38）和月经周期较长（0.54，95%CI：0.39-0.75）与肺癌发生风险相关。亚洲地区非吸烟女性肺部疾病/家族肺癌史/所有癌症史与肺癌发生呈正相关（1.82，95%CI：1.60-2.07）。与其他地区不同，烹饪因素是亚洲地区非吸烟女性发生肺癌的主要危险因素。
荟萃分析表明，烹饪习惯、饮食、被动吸烟、癌症和肺部疾病史、女性生殖因素与非吸烟女性肺癌有关，但需要更多的研究来验证这一发现。
