Risk factors for primary lung cancer among never-smoking women in South Korea: A retrospective nationwide population-based cohort study

Yoon Ho Ko, Seung Joon Kim, Wan Seop Kim, Chan Kwon Park, Cheol Kyu Park, Yang Gun Suh, Jung Seop Eom, Sukki Cho, Jae Young Hur, Sung Ho Hwang, Jun Pyo Myong

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6 Citations (Scopus)


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 fac-tor; 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 nev-er-smoking females. Thus, lifestyle modifications may help prevent lung cancer.

Original languageEnglish
Pages (from-to)692-702
Number of pages11
JournalKorean Journal of Internal Medicine
Issue number3
Publication statusPublished - 2020 May

Bibliographical note

Publisher Copyright:
© 2020 The Korean Association of Internal Medicine.


  • Cohort studies
  • Lung neoplasm
  • Never-smoking women
  • Risk factor

ASJC Scopus subject areas

  • Internal Medicine


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