Association of cognitive factors with lung cancer risk in the UK Biobank cohort.

Abstract

e23006 Background: Previous studies suggest that cognitive reserve, encompassing factors like education, occupation, and physical activity, may influence mortality risk. However, the relationship between cognitive reserve and cancer incidence, particularly lung cancer, remains underexplored. This study investigates the association between cognitive factors and the risk of lung cancer among participants in the UK Biobank Cohort. Methods: 229,198 UK Biobank participants who were cancer-free at baseline (31.07.2010) and recruited between 2006 and 2010 were the subjects of this prospective cohort study. Cognitive reserve was evaluated based on education, occupation, and physical activity levels. In this study, we utilized the Cox proportional hazards model to assess the hazard ratios (HR) and 95% confidence intervals (CI) of the association between cognitive factors and lung cancer. We also applied the Schoenfeld residuals to test the Cox proportional hazards assumption. The impact of the covariate "smoking" on the statistical outcomes was eliminated when we constructed a 1/2/3 multivariate model. Subgroup analyses by age and BMI were also carried out. Results: 1075 participants eventually developed lung cancer as a result of follow-up. Comparing participants with higher education to those with less than a bachelor's degree, the multivariate corrected HR for the former was 0.77 (0.65-0.91). Furthermore, subgroup analyses among individuals aged 60+ and with a BMI < 25 showed results in line with the above (HR:0.69, 95%CI 0.52 to 0.91; HR:0.67, 95%CI 0.53 to 0.85). Conclusions: In this study, we showed that, when smoking was taken out of the equation, higher education was substantially linked to a lower risk of lung cancer. However, the aforementioned statistical significance was more significant in the older individuals (≥60 years) and lower BMI (＜25kg/m 2 ) groups. HR (95% CI) of incident lung cancer according to model 1/2/3. Category Cases Model 1HR (95%CI) Model 2HR (95%CI) Model 3HR (95%CI) Edu  Non-university degree 137,309 1.00(reference) 1.00(reference) 1.00(reference)  University degree 91,889 0.75(0.64-0.87) 0.77(0.66-0.9) 0.77(0.65-0.91) Job  Simple 25,621 1.00(reference) 1.00(reference) 1.00(reference)  Moderate 62,340 0.81(0.68-0.96) 0.86(0.72-1.03) 0.92(0.75-1.13)  Difficult 141,237 0.68(0.58-0.81) 0.71(0.59-0.85) 0.84(0.68-1.03) Physical activity  Low 180,374 1.00(reference) 1.00(reference) 1.00(reference)  Moderate 40,072 1.08(0.93-1.25) 1.05(0.9-1.23) 0.98(0.83-1.16)  High 8,752 1.13(0.87-1.47) 1.1(0.83-1.45) 1.06(0.78-1.44) Model 1 was adjusted for age, race, and BMI. Model 2 was adjusted for age, race, BMI, drinking status, and family history of lung cancer. Model 3 was adjusted for age, race, BMI, drinking status, family history of lung cancer, medicine use, and income.