Epidemiology and Health最新文献

{"title":"Workplace outbreak of enterotoxigenic Escherichia coli O159 enteritis linked to kimchi consumption in Daejeon, Korea, 2024.","authors":"Ji Hae Hwang, Eun Mi Song, Eun Ho Jeong, Joo Yeon Kim, Jin Hee Kim, Hyun Jin Kim, Soyeon Nam, Jiyeon Cheon, Eunkyung Shin, Wooju Kang, Junyoung Kim, Hae-Sung Nam","doi":"10.4178/epih.e2026031","DOIUrl":"10.4178/epih.e2026031","url":null,"abstract":"<p><strong>Objectives: </strong>In August 2024, a large outbreak of gastrointestinal illness was reported among workers at a workplace in Daejeon, Korea, where bulk meals were served. This study investigated the epidemiological and microbiological characteristics of the outbreak to identify the causative pathogen, the infection source, and possible contamination routes.</p><p><strong>Methods: </strong>A comprehensive epidemiological investigation was conducted, including case identification, retrospective cohort analysis, laboratory confirmation, and pulsed-field gel electrophoresis (PFGE). Attack rates, relative risks (RRs), and 95% confidence intervals (CIs) were calculated. Environmental and distribution chain assessments were also performed to trace the sources and transmission pathways.</p><p><strong>Results: </strong>A total of 77 individuals met the case definition, including 75 symptomatic cases and 2 asymptomatic food handlers who tested positive for enterotoxigenic Escherichia coli (ETEC) O159. Among the 75 symptomatic cases, 25 were laboratory-confirmed, resulting in a total of 27 laboratory-confirmed cases. The mean and median incubation periods were 70.5 hours and 72.0 hours, respectively. The attack rate was significantly higher among kimchi consumers than among non-consumers (RR, 1.47; 95% CI, 1.08 to 2.00). PFGE identified ETCX01.332 as the predominant pattern among patient and kimchi isolates. Distribution tracing indicated that the implicated kimchi was produced at a factory in Gyeonggi Province and supplied to multiple catering facilities, leading to additional outbreaks in Seoul and Gyeonggi Province. However, the exact contamination point(s) during production or distribution remained undetermined.</p><p><strong>Conclusions: </strong>This outbreak was attributed to ETEC O159, with kimchi suspected as the infection source. These findings provide rare evidence implicating non-heated fermented foods in ETEC transmission and highlight the need for strengthened hygiene standards and real-time monitoring throughout the production, distribution, and handling of fermented foods.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026031"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Device-related differences in blood pressure measurement and their impact on hypertension prevalence in Korean children and adolescents.","authors":"Sung Hye Kim, Yu-Mi Kim, Hack-Lyoung Kim, Sang Min Park, In-Jeong Cho, Dae-Hee Kim, Kwang-Il Kim, Jinho Shin, Kyungwon Oh, Eun Mi Lee","doi":"10.4178/epih.e2026037","DOIUrl":"10.4178/epih.e2026037","url":null,"abstract":"<p><strong>Objectives: </strong>Accurate blood pressure (BP) measurement is essential for reliably estimating hypertension prevalence in population-based surveys. However, evidence supporting the use of oscillometric BP devices in pediatric populations remains limited. This study compared BP measurements obtained using an oscillometric device (OD) and an auscultatory device (AD) and evaluated inter-device agreement and the impact of device choice on hypertension prevalence estimates.</p><p><strong>Methods: </strong>BP was measured sequentially with the AD and OD in 251 children and adolescents participating in the Korea National Health and Nutrition Examination Survey. Inter-device agreement was assessed using mean differences, limits of agreement, concordance correlation coefficients (CCCs), and regression analyses. Differences in prevalence estimates for elevated blood pressure (EBP) and hypertension were also examined.</p><p><strong>Results: </strong>Mean inter-device differences were minimal for systolic blood pressure (SBP; 0.2±5.9 mmHg) but negative for diastolic blood pressure (DBP; -1.5±6.1 mmHg), with larger discrepancies in older girls. Agreement was moderate to good for SBP (CCC=0.79) and weaker for DBP (CCC=0.60). Nevertheless, more than 85% of paired measurements were within ±10 mmHg. Prevalence estimates for EBP (11.6 vs. 10.0%) and hypertension (4.8 vs. 4.4%) were comparable between devices, with relatively high negative agreement and overall agreement.</p><p><strong>Conclusions: </strong>Despite modest underestimation of DBP in specific subgroups, oscillometric BP measurement showed acceptable agreement with the auscultatory method and yielded similar hypertension prevalence estimates. These findings suggest that ODs may be useful for pediatric BP measurement in public health surveillance systems.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026037"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Plan and operations of the 10th Korea National Health and Nutrition Examination Survey (2025-2027).","authors":"Sun-Ja Kim, Sihyun Park, Sunja Kim, Suyeon Park, Yoonjung Kim, Yunjung Choi, Sungha Yun, Kyungwon Oh","doi":"10.4178/epih.e2026001","DOIUrl":"10.4178/epih.e2026001","url":null,"abstract":"<p><p>The Korea National Health and Nutrition Examination Survey (KNHANES) is a national health survey mandated by Article 16 of the National Health Promotion Act to assess the health and nutritional status of the Korean population. Over the past 2 decades, the survey has continuously introduced timely survey components while strengthening its survey methodology and operational systems to enhance both the policy relevance and scientific utility of its findings. The 10th KNHANES (2025-2027) preserves the statistical representativeness of its sampling design while expanding the use of web-based self-administered questionnaires to improve participant convenience. In response to Korea's transition into a super-aged society, the 10th KNHANES incorporates enhanced older-adult health surveys, including osteoporosis assessment and older adults' life functioning, and newly introduces items addressing social support as part of the social determinants of health. In addition, a longitudinal follow-up survey system has been established to monitor long-term changes in population health. Collectively, these changes are expected to improve understanding of aging-related health issues, support evidence-based national health policy development, and expand the applicability of KNHANES data for academic research.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026001"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12946570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145935567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between cardiovascular health measured by Life's Essential 8 and depressive symptoms.","authors":"Jeong Hyun Ahn, Hyejin Kim, Hyeon Chang Kim, Hokyou Lee, Younga Heather Lee, Donald M Lloyd-Jones, Sun Jae Jung","doi":"10.4178/epih.e2026013","DOIUrl":"10.4178/epih.e2026013","url":null,"abstract":"<p><strong>Objectives: </strong>Poor cardiovascular health (CVH) and the high prevalence of depressive symptoms represent significant public health concerns, underscoring the importance of examining their association. This study aimed to investigate the association between CVH, as defined by the American Heart Association's 2022 Life's Essential 8 (LE8) framework, and depressive symptoms.</p><p><strong>Methods: </strong>This study used data from the 2014, 2016, 2018, and 2020 Korea National Health and Nutrition Examination Survey. Overall CVH, measured using LE8, was categorized into 3 groups: low score (0-<50), moderate score (50-<80), and high score (80-100). LE8 comprises 2 subdomains: health behaviors and health factors. Depressive symptoms were defined as a total score ≥10 on the Patient Health Questionnaire-9. Multiple logistic regression analyses were performed, adjusting for sex, age, socioeconomic status, and current drinking status.</p><p><strong>Results: </strong>Among 17,294 adults, 257 male and 681 female reported significant depressive symptoms. Compared with individuals in the low LE8 category (reference), the odds ratio (OR) for depressive symptoms was 0.29 (95% confidence interval [CI], 0.21 to 0.40) for those in the high LE8 category. The OR for depressive symptoms was 0.39 (95% CI, 0.29 to 0.53) for individuals with a high health behavior score compared with those with a low health behavior score. In contrast, the health factor score was not significantly associated with depressive symptoms.</p><p><strong>Conclusions: </strong>These findings suggest that overall CVH, particularly the health behavior subdomain, was associated with lower odds of depressive symptoms. Prospective longitudinal studies are warranted to validate these findings and clarify the directionality of the observed associations.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026013"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219981/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147487556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of chronic lung disease, insufficient sleep, and pain with incident frailty in Chinese middle-aged and older adults.","authors":"Wenyan Hu, Lifang Chen, Tingyan Li, Yongping Gu","doi":"10.4178/epih.e2026016","DOIUrl":"10.4178/epih.e2026016","url":null,"abstract":"<p><strong>Objectives: </strong>Chronic lung disease, insufficient sleep, and chronic pain are prevalent among middle-aged and older adults and may synergistically accelerate frailty. This study was conducted to examine the independent and combined associations of chronic lung disease, insufficient sleep, and pain with frailty risk among middle-aged and older Chinese adults.</p><p><strong>Methods: </strong>This study used data from the China Health and Retirement Longitudinal Study. Multivariable logistic regression and mediation analyses were used to examine the associations among chronic lung disease, insufficient sleep, pain, and frailty. Pain was categorized into any bodily pain and chest pain, with the latter analyzed separately due to its potential relationship with chronic lung disease. Subgroup analyses stratified by age and sex were also conducted to assess effect modification.</p><p><strong>Results: </strong>Chronic lung disease combined with insufficient sleep (odds ratio [OR], 2.71; 95% confidence interval [CI], 1.70 to 4.22), pain (OR, 3.04; 95% CI, 1.86 to 4.86), or chest pain (OR, 2.58; 95% CI, 1.07 to 5.56) was significantly associated with higher odds of frailty. Subgroup analyses showed an interaction among chronic lung disease, chest pain, and age (p for interaction <0.05). Mediation analysis indicated that sleep, pain, and chest pain mediated 10.1%, 26.2%, and 14.0% of the association between chronic lung disease and frailty.</p><p><strong>Conclusions: </strong>The combined presence of chronic lung disease with insufficient sleep or pain was associated with an increased risk of incident frailty. Screening and interventions targeting these factors may help mitigate frailty among middle-aged and older adults.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026016"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503062/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The evolution of sampling in epidemiology: from classical probability models to AI-enhanced recruitment and active learning.","authors":"Sulaiman Abubakar Musa","doi":"10.4178/epih.e2026019","DOIUrl":"10.4178/epih.e2026019","url":null,"abstract":"<p><p>Sampling is a foundational element of epidemiological research because it determines the validity, efficiency, and generalizability of population-based inferences. Classical probability and non-probability sampling methods have long underpinned public health study design by providing robust frameworks for unbiased estimation and causal inference. However, the rapid expansion of digital health data, electronic health records, and large-scale online cohorts has exposed important limitations in these largely static sampling frameworks. This narrative review traces the evolution of sampling in epidemiology from traditional probability-based designs to contemporary artificial intelligence-enhanced recruitment strategies, with particular emphasis on active learning and adaptive sampling. By synthesizing classical statistical theory with emerging machine-learning approaches and recent methodological advances, this review argues that the future of epidemiological sampling lies in hybrid frameworks that preserve statistical rigor while leveraging algorithm-driven adaptability. Methodological opportunities, ethical risks, and implications for low-income and middle-income countries are critically examined.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026019"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934790","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of morbidity on the association between lifestyle and mortality in the Health Examinee cohort.","authors":"Abraham Kaggwa, Anthony Kityo, Sang-Ah Lee","doi":"10.4178/epih.e2026022","DOIUrl":"10.4178/epih.e2026022","url":null,"abstract":"<p><strong>Objectives: </strong>Healthy lifestyles are associated with lower mortality risk, but evidence among Asian populations with multimorbidity remains limited. We examined the association between lifestyle and all-cause mortality, stratified by morbidity status.</p><p><strong>Methods: </strong>We analysed 111,537 Korean adults aged 40-69 years from the Health Examinee cohort (2004-2020). Five lifestyle factors-smoking (pack-years), alcohol intake (g/day), physical activity (MET-hr/day), sleep duration (hr/day), and diet quality, assessed using the Korean Diet Quality Index-were standardised and regressed on mortality. Regression coefficients were positive for high-risk behaviours and negative for protective behaviours; these coefficients were summed to generate a weighted lifestyle score (WLS), with higher values indicating a less healthy lifestyle. We estimated hazard ratios (HRs) per standard deviation (SD) increase in WLS and across WLS tertiles (T1=healthiest, T3=least healthy), as well as years of life lost (YLL), stratified by morbidity status (none, 1 condition, or multimorbidity).</p><p><strong>Results: </strong>During a median follow-up of 10.6 years, 3,366 deaths occurred. A higher WLS was associated with a 21% increase in mortality risk among participants with multimorbidity. HRs and 95% confidence intervals (CIs) for T3 versus T1 were 1.40 (95% CI, 1.13 to 1.74) among participants with no disease, 1.68 (95% CI, 1.39 to 2.03) among those with 1 disease, and 1.62 (95% CI, 1.31 to 2.01) among those with multimorbidity. Associations were stronger among females with multimorbidity. At age 40 years, T3 was associated with YLL of 4.9 years in males and 4.3 years in females with multimorbidity.</p><p><strong>Conclusions: </strong>A higher lifestyle score, indicating a less healthy lifestyle, was associated with reduced life expectancy, particularly among individuals with multimorbidity. These findings highlight the potential benefits of adopting a healthy lifestyle in this population subgroup.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026022"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13503064/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148145283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbidity network of post-traumatic stress and depressive symptoms during the COVID-19 pandemic in Korea.","authors":"Yujin Lee, Ji Su Yang, Alexander C Tsai, Jee In Kang, Hearan Koo, Hyeon Woo Yim, Hyeon Chang Kim, Sun Jae Jung","doi":"10.4178/epih.e2026006","DOIUrl":"10.4178/epih.e2026006","url":null,"abstract":"<p><strong>Objectives: </strong>The coronavirus disease 2019 (COVID-19) pandemic had direct effects on population health through infection and morbidity, as well as indirect effects on population mental health. We estimated the network structure of post-traumatic stress symptoms (PTSS) and depressive symptoms throughout the pandemic in Korea and aimed to identify the most central and bridging symptoms.</p><p><strong>Methods: </strong>Participants aged 30-64 years completed mental health surveys across 3 phases of the COVID-19 pandemic: March 2020 (n=1,925), February-March 2021 (n=1,754), and December 2021-January 2022 (n=1,595). Using PTSS and depressive symptom data, we conducted network analyses, and the primary measures of symptom importance (centrality) were expected influence and bridge expected influence.</p><p><strong>Results: </strong>In the comorbidity network, although the most central symptoms fluctuated over the course of the pandemic, sleep problems were consistently identified as the most influential bridge symptoms throughout. The symptom network structure differed between the subacute and chronic phases of the pandemic.</p><p><strong>Conclusions: </strong>We found evidence of changes in the network structure of PTSS and depressive symptoms, even as sleep problems retained a consistent role as a bridging symptom. Although overall network structures varied across phases of the pandemic, the bridging role of sleep-related symptoms remained consistently strong, suggesting that sleep problems may represent a general and enduring mechanism underlying PTSS-depression comorbidity. During future pandemics, prompt screening for sleep problems may help prevent the development of comorbidity between PTSS and depressive symptoms.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026006"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13034016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146087680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Confounding and the healthy worker survivor effect in studies of medical radiation workers: a systematic review of methodological approaches.","authors":"Eun Jung Park, Kyoungyeol Yuk, Jaeho Jeong, Won Jin Lee","doi":"10.4178/epih.e2026009","DOIUrl":"10.4178/epih.e2026009","url":null,"abstract":"<p><p>Confounding and the healthy worker survivor effect (HWSE) represent major methodological challenges in epidemiology, particularly in studies of low-dose exposures, where effect sizes are small and risk estimates can be readily distorted by bias. This systematic review aimed to summarize the methods used to adjust for confounding and the HWSE in studies of medical radiation workers. We systematically searched PubMed and Embase for studies of medical radiation workers from inception through June 30, 2025. Studies reporting excess risk estimates for any health outcomes associated with occupational radiation exposure were included. Study selection followed the PECO (Population, Exposure, Comparator, Outcome) criteria, and data were synthesized descriptively. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and was registered in PROSPERO (CRD42024589851). Sixteen eligible studies from 3 countries were identified, all of which were rated as high quality. To control for confounding, regression was used in all studies, followed by stratification (62.5%) and restriction (18.8%). Age, sex, and birth year were adjusted for in all models, with smoking being the next most frequently controlled variable. To mitigate the HWSE, only a single approach, adjustment for employment characteristics, was identified, and it was applied in 3 studies (18.8%). No other approaches, including restriction or g-methods, were employed. Although confounding is generally addressed using conventional analytical approaches, the HWSE has rarely been considered in studies of medical radiation workers. More comprehensive strategies that explicitly account for the HWSE are needed to improve the validity of risk estimates, particularly in low-dose occupational studies.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026009"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13033441/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146126985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latency period of lung cancer in relation to tobacco smoking in Korea.","authors":"Thi Tra Bui, Hee-Yeon Kang, Eunjung Park, Jin-Kyoung Oh","doi":"10.4178/epih.e2026014","DOIUrl":"10.4178/epih.e2026014","url":null,"abstract":"<p><strong>Objectives: </strong>This mixed-methods observational study aimed to examine the temporal relationship between trends in cigarette smoking prevalence and lung cancer mortality and incidence rates, and to estimate the latency period between smoking initiation and lung cancer diagnosis among smokers at the individual level.</p><p><strong>Methods: </strong>Smoking prevalence data for 1960-2022 were reconstructed using data from the Korea National Health and Nutrition Examination Survey (1998-2022). Lung cancer mortality data (1983-2022) and incidence data (1999-2022) were obtained from Statistics Korea and the Korea Central Cancer Registry. The population latency period was estimated using peak comparison and distributed lag non-linear models. The individual latency period was estimated as the average time interval between age at smoking initiation and age at lung cancer diagnosis using individual-level data from the National Health Insurance Service cohort.</p><p><strong>Results: </strong>In men, smoking prevalence peaked around 1985, whereas lung cancer mortality peaked around 2000 during 1960-2022, indicating a lag time of approximately 15 years. In women, lung cancer mortality peaked in 2002, while smoking prevalence peaked around the same time. The population-level latency period between smoking and lung cancer incidence was estimated to be 15 years after adjustment for age, gender, and year of outcome. The individual latency period was estimated to be 42.6 years (standard deviation [SD], 12.5) in men and 34.4 years (SD, 14.2) in women. Smoking intensity and age at initiation did not appear to shorten the individual latency period.</p><p><strong>Conclusions: </strong>Estimates of the smoking-attributable lung cancer burden should account for historical smoking prevalence from approximately 15 years earlier.</p>","PeriodicalId":48543,"journal":{"name":"Epidemiology and Health","volume":" ","pages":"e2026014"},"PeriodicalIF":2.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13219974/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147647124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}