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Inflammatory indicators associated with increased lung cancer incidence in Kailuan cohortHigh Inflammatory Markers Linked to Higher Lung Cancer Risk in Older Adults

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Key Takeaway
Note SIRI and AISI associations with lung cancer incidence in a large cohort without inferring causation.

This prospective cohort study analyzed 99,925 participants from the Kailuan cohort with a mean follow-up duration of 14.85 years. The investigation examined 15 inflammatory indicators, including white blood cell count, monocytes, lymphocytes, neutrophils, CLR, SIRI, and AISI, against the incidence of overall and subtype-specific lung cancer.

Per 1 Z-score increase, overall lung cancer risk demonstrated a significant association with an HR of 1.112 (95% CI: 1.064–1.163). Specific indicators showed varying magnitudes, such as SIRI with an HR of 1.536 (95% CI: 1.183–1.995) and AISI with an HR of 1.070 (95% CI: 1.023–1.119). For 10-year risk, SIRI was associated with an increased risk by 75.7% (HR = 1.757, 95% CI: 1.350–2.278), while AISI showed an increased risk by 9.0% (HR = 1.090, 95% CI: 1.029–1.154).

SIRI showed significant positive associations with squamous cell carcinoma (HR = 1.782, 95% CI: 1.352–2.350) and other pathological types (HR = 1.638, 95% CI: 1.263–2.125). No significant association was reported for adenocarcinoma or small cell lung cancer. Safety data regarding adverse events were not reported in the study. Evidence on association with incident risk across pathological subtypes remains limited.

SIRI and AISI are independent risk factors, particularly for squamous cell carcinoma, in individuals aged ≥ 60 years. Associations are reported as significant associations, not necessarily causation.

Researchers followed 99,925 participants in the Kailuan cohort for an average of 14.85 years to track lung cancer development. They measured 15 different inflammatory indicators, including white blood cell counts and specific scores like SIRI and AISI. The study found that higher levels of these markers were associated with a greater risk of overall lung cancer and specific subtypes. For instance, a specific score called SIRI was linked to a 75.7% higher risk over 10 years for some participants.

The link was strongest for squamous cell carcinoma in adults aged 60 and older. Other types of lung cancer, such as adenocarcinoma and small cell lung cancer, did not show a significant connection to these specific inflammatory markers in this group. The researchers noted that these findings apply to the general population within the cohort, not just those with existing health issues.

While chronic inflammation is known to drive cancer development, this study reports associations rather than proving that these markers directly cause cancer. The results suggest that monitoring these inflammatory signs could help identify higher-risk individuals, particularly older adults. However, more research is needed to confirm these links across different populations and to understand exactly how these markers influence cancer growth.

What this means for you:
Higher inflammatory markers are linked to increased lung cancer risk, especially squamous cell carcinoma in adults over 60.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
Chronic inflammation drives lung cancer pathogenesis; however, evidence on its association with incident risk across pathological subtypes remains limited. To evaluate associations of 15 inflammatory indicators with long-term and 10-year risk of overall and subtype specific lung cancer. This study included 99, 925 participants from the Kailuan cohort (mean follow-up, 14.85 years). During follow-up, 1, 804 incident lung cancer cases were identified. After multivariable adjustment and false discovery rate correction, several inflammatory markers, particularly the novel composite indices SIRI and AISI, were significantly associated with increased overall lung cancer risk. Per 1 Z-score increase, white blood cell count (HR = 1.112, 95% CI: 1.064–1.163), monocytes (HR = 1.060, 95% CI: 1.033–1.087), lymphocytes (HR = 1.050, 95% CI: 1.014–1.087), neutrophils (HR = 1.083, 95% CI: 1.037–1.130), CLR (HR = 1.031, 95% CI: 1.006–1.058), SIRI (HR = 1.536, 95% CI: 1.183–1.995), and AISI (HR = 1.070, 95% CI: 1.023–1.119) showed significant associations. For 10-year risk, similar associations were observed, with SIRI and AISI increasing risk by 75.7% (HR = 1.757, 95% CI: 1.350–2.278) and 9.0% (HR = 1.090, 95% CI: 1.029–1.154), respectively. Subtype analyses revealed significant positive associations for squamous cell carcinoma (e.g., SIRI: HR = 1.782, 95% CI: 1.352–2.350) and other pathological types (e.g., SIRI: HR = 1.638, 95% CI: 1.263–2.125) but not for adenocarcinoma or small cell lung cancer. Stratified analyses showed effect modification by age for SIRI in overall lung cancer (stronger in participants aged ≥60 years), and by sex, age, and smoking status for multiple markers in subtype-specific analyses. SIRI showed the strongest effects across all analyses. Chronic inflammation is differentially associated with lung cancer risk by subtype; SIRI and AISI are independent risk factors, with SIRI showing the strongest effects, particularly for squamous cell carcinoma, in individuals aged ≥ 60 years, and these associations are modified by sex and smoking status.
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