Aug 2026· Cancer Epidemiology· Vol 104, pp.
103192
· 0 citations· 54 references
Medicine
TL;DR
The co-occurrence of diabetes and tuberculosis may simultaneously influence the risk of lung cancer, potentially through altered lipid metabolism, potentially through altered lipid metabolism.
Abstract
Background
Obesity and diabetes are risk factors for cancer at many organ sites. However, their associations with lung cancer remain inconclusive. This study aims to explore the role of diabetes and its interaction patterns with risk factors for lung cancer among the general population.
Methods
A territory-wide retrospective cohort study was conducted using electronic health records of Hong Kong. Patients who utilized public healthcare services between 1997 and 2021 without cancer history were identified. Patients were followed up until December 31st, 2021. The role of diabetes and its interaction patterns with risk factors for lung cancer were examined using conditional inference survival tree.
Results
Of the 191,999 patients included, 2303 patients developed lung cancer during a median follow-up of 6.25 years. Ever smoking, older age, lower LDL cholesterol, the presence of diabetes, and tuberculosis status exhibited an interaction pattern on the risk of lung cancer. Among old ever smokers aged 60 years above characterized by low lipids, the co-occurrence of diabetes and tuberculosis emerged as a key risk factor. In post-hoc analyses, diabetes exhibited interactions with age and lipid profile in ever smokers as well as age alone in never smokers among statin users, but not for statin non-users.
Conclusions
The co-occurrence of diabetes and tuberculosis may simultaneously influence the risk of lung cancer, potentially through altered lipid metabolism. It is possible that the opposite characteristics of lipid profile associated with diabetes and tuberculosis may add complexity to the observed association between diabetes and lung cancer. These epidemiological observations may warrant further investigation to validate the findings and future experimental research to elucidate underlying mechanisms.
BACKGROUND
Lung cancer is a leading contributor to global cancer incidence and mortality. While depression has been linked to adverse health behaviors, particularly tobacco smoking, that may elevate cancer risk, the direct relationship between depression and lung cancer remains uncertain. We aimed to clarify this association in a large cohort of Korean women.
METHODS
We analyzed data from the Korean National Health Information Database for women who completed the national health screening in 2012. A total of 2,032,241 participants aged 20 years or older were followed until December 2022. Depression was defined using insurance claims within the year preceding the baseline exam. Lung cancer cases were ascertained through matched health insurance and critical illness registration records. Adjusted hazard ratios (aHR) were calculated using multivariable Cox proportional hazards models.
RESULTS
Over a mean follow-up of 9.3 years, 11,706 women developed lung cancer. Those with depression experienced higher incidence rates (1.02 per 1,000 person-years) and a modestly increased risk (aHR 1.09, 95% confidence interval [CI] 1.02-1.16) compared with women without depression. Stratified analyses indicated stronger associations among women aged 40-64 years (aHR 1.13, 95% CI 1.04-1.24), and former smokers (aHR 2.33, 95% CI 1.66-3.28)-particularly former smokers with at least 20 pack-years of smoking exposure (aHR 4.93, 95% CI 2.55-9.51).
CONCLUSION
Depression was associated with elevated lung cancer risk in women, with effects modified by age and smoking history. Targeted interventions addressing mental health may contribute to lung cancer prevention, especially in susceptible subgroups.
C. Chung, Kyu Na Lee, Kyungdo Han et al.· Tuberculosis and Respiratory...· 0 citations
Pancreatic cancer is a highly lethal malignancy, and its incidence is increasing among younger individuals. Although smoking, alcohol use, and unhealthy diet are established risk factors, the cumulative impact of multiple lifestyle exposures on age at diagnosis remains unclear. This study aimed to estimate the combined burden of lifestyle and environmental risks associated with the timing of pancreatic cancer diagnosis.
We conducted a hospital-based retrospective case-only study including 134 patients diagnosed with pancreatic cancer between 2020 and 2025. Data on family history of pancreatic cancer, cigarette smoking, alcohol consumption, dietary patterns, exercise, and occupational chemical exposure were collected through structured interviews and medical record reviews. Cox proportional hazards models using age at diagnosis as the time scale were used to evaluate associations between exposures and earlier diagnosis. Lifestyle factors were integrated into a cumulative exposure index and analyzed using Cox models with adjustment for the remaining covariates.
The mean age at diagnosis was 64.8 years. A significant difference in age at diagnosis was observed across smoking categories, with current smokers having the youngest mean age, whereas no significant difference was observed across alcohol consumption categories. Patients with triple exposure had the youngest mean age at diagnosis (55.5 years), followed by those with double (63.5 years), single (64.8 years), and no (69.0 years) exposures. Compared with no exposure, single, double, and triple exposures were associated with progressively higher hazards of earlier diagnosis (HR = 1.79, 95% CI: 1.14–2.81,
p
= 0.011; HR = 2.97, 95% CI: 1.67–5.28,
p
< 0.001; and HR = 6.66, 95% CI: 3.35–13.22,
p
< 0.001, respectively).
Our findings indicate a significant association between a higher combined exposure index and earlier age at pancreatic cancer diagnosis. This exposure–response gradient suggests that a greater accumulation of adverse lifestyle exposures corresponds to earlier age at diagnosis among affected patients.
Not applicable.
Fu-Jen Lee, L. Chien, Jaw-Town Lin et al.· BMC Gastroenterology· 0 citations
Findings suggest that a comorbidity-pattern-based approach can improve the understanding of breast cancer risk and identify specific comorbidity or clinical conditions, particularly the metabolic and gynecologic–breast comorbidity patterns, could inform personalized risk stratification and targeted prevention strategies for breast cancer.
Ya-Ling Zhang, Bei Zhao, Xin-Chun Zhang et al.· Frontiers in Oncology· 0 citations
Breast cancer is the most prevalent malignancy among women worldwide. Smoking increases the risk of breast cancer and is associated with poorer treatment outcomes. Although smoking behaviour and cessation have been studied among breast cancer patients, the existing evidence remains heterogeneous, and the timing of cessation around diagnosis is not fully understood. The aim of this study was to determine the proportion of breast cancer patients who quit smoking after diagnosis and to identify factors associated with smoking cessation. In this retrospective study, the smoking status of 6456 consecutive breast cancer patients from years 2010 to 2022 was evaluated. All patients were requested to complete a baseline questionnaire including information on their smoking status. The follow-up information was collected from the patient records. At the time of diagnosis, 851 patients (13.2%) were actively smoking. Follow-up data were available for 736 patients (86.5%), of whom 189 (25.7%) quit smoking at the time of diagnosis despite the absence of a formal cessation program. Nearly half (44.7%) of all smoking cessation events occurring within the 5-year period before and after diagnosis took place within the year of diagnosis. Smoking cessation was significantly more likely at the time of diagnosis than during subsequent years. Cancer diagnosis provides a timely opportunity for smoking cessation and highlights the potential value of integrating smoking cessation interventions at the time of diagnosis.
Raakel Lintunen, A. Tamminen· Supportive Care in Cancer· 0 citations
It is recommended that patients with lung cancer undergo screening to assess their cardiovascular risk and related complications and it is recommended that patients with lung cancer undergo screening to assess their cardiovascular risk and related complications.
M. Mamedov, P. I. Skopin, A. K. Karimov· Russian Journal of Preventiv...· 0 citations
Evaluating the occurrence of new-onset CVD in women with breast cancer undergoing chemotherapy and identifying factors associated with increased risk of cardiovascular disease highlights the need for sustained cardiovascular surveillance in breast cancer survivors.
V. Dvorovy, L. Kováčová, M. Selvek et al.· European Heart Journal, Supp...· 0 citations
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