Epidemiology and Health

Original Article

Risk factors for early-onset lung cancer in Korea: analysis of a nationally representative population-based cohort: Jihun Kang, Taeyun Kim, Kyung-Do Han, Jin-Hyung Jung, Su-Min Jeong, Yo Hwan Yeo, Kyuwon Jung, Hyun Lee, Jong Ho Cho, Dong Wook Shin; Epidemiol Health. 2023;45:e2023101. Published online November 21, 2023; DOI: https://doi.org/10.4178/epih.e2023101

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Abstract Summary PDF Supplementary Material: 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.; Summary

Korean summary
나이, 여성, 흡연, 그리고 대사 증후군은 조기 발생 폐암의 위험도 증가와 연관이 있었다. 반면에 높은 소득, 신체 활동, 비만은 젊은 성인에서 폐암 발생의 위험도 감소와 연관성을 나타내었다.

Key Message
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 on the development of lung cancer in young adults.

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