Environmental risk factors, protective factors and lifestyles for lung cancer: an umbrella review

作者：Minghao Feng, Feng Wang, Minwei Bao, Lei Zhu · 发表于：Frontiers in Public Health · 年份：2025 · DOI：10.3389/fpubh.2025.1623840 · 被引用次数：9 · 研究领域：Health, Environment, Cognitive Aging、Nutritional Studies and Diet、Carcinogens and Genotoxicity Assessment

Background: Lung cancer remains a leading cause of cancer-related mortality worldwide, with environmental exposures and lifestyle factors playing a crucial role in its etiology. This umbrella review aims to systematically assess and classify the strength of evidence for environmental and lifestyle factors associated with lung cancer risk. Methods: ), small-study effects, and excess significance bias. The evidence was categorized into convincing (Class I), highly suggestive (Class II), suggestive (Class III), and weak or non-significant associations. Results: A total of 58 meta-analyses covering 34 environmental factors and 24 lifestyle factors were included. Three environmental exposures-cadmium exposure (RR = 1.24, 95% CI: 1.18-1.29), diesel exhaust exposure (RR = 1.16, 95% CI: 1.13-1.18), and occupational exposure to paints (OR = 1.40, 95% CI: 1.29-1.51)-were classified as convincing evidence (Class I). Fifteen additional environmental factors, including secondhand smoke, benzene, formaldehyde, and indoor coal use, were classified as highly suggestive evidence (Class II). Among lifestyle factors, cooking-related exposures (OR = 1.21, 95% CI: 1.10-1.31) showed a convincing association with lung cancer risk, while dietary cholesterol intake (OR = 1.40, 95% CI: 1.20-1.64) and the Western dietary pattern (RR = 1.29, 95% CI: 1.01-1.66) were classified as highly suggestive evidence. Dietary patterns associated with reduced lung cancer risk included the Mediterranean diet (RR = 0....