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 factor; 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 never-
smoking females. Thus,
lifestyle modifications may help prevent
lung cancer.