{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T21:04:02Z","timestamp":1793307842639,"version":"4.5.0"},"reference-count":83,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T00:00:00Z","timestamp":1753142400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic search of published meta-analyses was conducted from database inception until January 31, 2025. Eligible meta-analyses included those evaluating associations between environmental or lifestyle exposures and lung cancer risk, with effect sizes reported as risk ratio (RR), odds ratios (OR), or standardized mortality ratios (SMR). The credibility of associations was assessed using statistical significance, heterogeneity (<jats:italic>I<\/jats:italic><jats:sup>2<\/jats:sup>), 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 58 meta-analyses covering 34 environmental factors and 24 lifestyle factors were included. Three environmental exposures\u2014cadmium exposure (RR\u202f=\u202f1.24, 95% CI: 1.18\u20131.29), diesel exhaust exposure (RR\u202f=\u202f1.16, 95% CI: 1.13\u20131.18), and occupational exposure to paints (OR\u202f=\u202f1.40, 95% CI: 1.29\u20131.51)\u2014were 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\u202f=\u202f1.21, 95% CI: 1.10\u20131.31) showed a convincing association with lung cancer risk, while dietary cholesterol intake (OR\u202f=\u202f1.40, 95% CI: 1.20\u20131.64) and the Western dietary pattern (RR\u202f=\u202f1.29, 95% CI: 1.01\u20131.66) were classified as highly suggestive evidence. Dietary patterns associated with reduced lung cancer risk included the Mediterranean diet (RR\u202f=\u202f0.87, 95% CI: 0.82\u20130.93) and the prudent dietary pattern (RR\u202f=\u202f0.80, 95% CI: 0.64\u20130.96), both of which were significantly associated with lower lung cancer risk. Heterogeneity was substantial in 48.57% of environmental associations and 39.13% of lifestyle associations, highlighting potential confounding factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This umbrella review highlights multiple environmental and lifestyle exposures with strong or suggestive associations with lung cancer. These findings support stricter environmental regulations, workplace protections, and lifestyle interventions. Future research should prioritize biomarker-based exposure assessments and long-term cohort studies to refine risk estimates and inform prevention strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic review registration<\/jats:title><jats:p>The study is registered with PROSPERO, number 1003974.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2025.1623840","type":"journal-article","created":{"date-parts":[[2025,7,22]],"date-time":"2025-07-22T05:31:17Z","timestamp":1753162277000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Environmental risk factors, protective factors and lifestyles for lung cancer: an umbrella review"],"prefix":"10.3389","volume":"13","author":[{"given":"Minghao","family":"Feng","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minwei","family":"Bao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"229","DOI":"10.3322\/caac.21834","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray","year":"2024","journal-title":"CA Cancer J Clin"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global Cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1348","DOI":"10.3390\/ijerph15071348","article-title":"Meta-analysis and systematic review in environmental tobacco smoke risk of female lung cancer by research type","volume":"15","author":"Ni","year":"2018","journal-title":"Int J Environ Res Public Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"906","DOI":"10.1289\/ehp\/1408092","article-title":"Outdoor particulate matter exposure and lung cancer: a systematic review and meta-analysis","volume":"122","author":"Hamra","year":"2014","journal-title":"Environ Health 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Med"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1007\/s00520-022-07542-0","article-title":"Effectiveness of healthy lifestyle-based interventions in lung cancer survivors: a systematic review and meta-analysis","volume":"31","author":"Heredia-Ciur\u00f3","year":"2022","journal-title":"Support Care Cancer"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"913","DOI":"10.1007\/s10552-022-01566-x","article-title":"Lifestyle factors and lung cancer risk among never smokers in the Canadian Partnership for Tomorrow's health (CanPath)","volume":"33","author":"Murphy","year":"2022","journal-title":"Cancer Causes Control"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"177","DOI":"10.1016\/0197-2456(86)90046-2","article-title":"Meta-analysis in clinical trials","volume":"7","author":"DerSimonian","year":"1986","journal-title":"Control Clin Trials"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"820","DOI":"10.7326\/0003-4819-127-9-199711010-00008","article-title":"Quantitative synthesis in systematic reviews","volume":"127","author":"Lau","year":"1997","journal-title":"Ann Intern Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1111\/j.1467-985X.2008.00552.x","article-title":"A re-evaluation of random-effects meta-analysis","volume":"172","author":"Higgins","year":"2009","journal-title":"J R Stat Soc Ser A Stat Soc"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"1158","DOI":"10.1093\/ije\/dyn204","article-title":"Commentary: heterogeneity in meta-analysis should be expected and appropriately quantified","volume":"37","author":"Higgins","year":"2008","journal-title":"Int J Epidemiol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"3127","DOI":"10.1002\/1097-0258(20001130)19:22<3127::aid-sim784>3.0.co;2-m","article-title":"A simple method for converting an odds ratio to effect size for use in meta-analysis","volume":"19","author":"Chinn","year":"2000","journal-title":"Stat Med"},{"key":"ref15","doi-asserted-by":"crossref","first-page":"101","DOI":"10.2307\/3001666","article-title":"The combination of estimates from different experiments","volume":"10","author":"Cochran","year":"1954","journal-title":"Biometrics"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"914","DOI":"10.1136\/bmj.39343.408449.80","article-title":"Uncertainty in heterogeneity estimates in meta-analyses","volume":"335","author":"Ioannidis","year":"2007","journal-title":"BMJ"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1136\/bmj.315.7109.629","article-title":"Bias in meta-analysis detected by a simple, graphical test","volume":"315","author":"Egger","year":"1997","journal-title":"BMJ"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"245","DOI":"10.1177\/1740774507079441","article-title":"An exploratory test for an 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1990 to 2019","volume":"19","author":"Zhou","year":"2024","journal-title":"J Thorac Oncol"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"986","DOI":"10.1038\/s41416-025-02999-2","article-title":"Particulate matter air pollution as a cause of lung cancer: epidemiological and experimental evidence","volume":"132","author":"Wang","year":"2025","journal-title":"Br J Cancer"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3109\/08958378.2012.691913","article-title":"Health effects research and regulation of diesel exhaust: an historical overview focused on lung cancer risk","author":"Hesterberg","year":"2012","journal-title":"Inhal Toxicol"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"11206","DOI":"10.1007\/s11356-017-8755-5","article-title":"PM2.5 emissions from different types of heavy-duty truck: a case study and meta-analysis of the Beijing-Tianjin-Hebei region","volume":"24","author":"Song","year":"2017","journal-title":"Environ Sci 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Oncol","author":"Fitzmaurice","year":"2017"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1097\/JOM.0000000000000337","article-title":"Lung cancer risk among cooks when accounting for tobacco smoking: a pooled analysis of case-control studies from Europe, Canada, New Zealand, and China","volume":"57","author":"Bigert","year":"2015","journal-title":"J Occup Environ Med"},{"key":"ref51","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1007\/s10552-015-0621-5","article-title":"Association of total cancer and lung cancer with environmental exposure to cadmium: the meta-analytical evidence","volume":"26","author":"Nawrot","year":"2015","journal-title":"Cancer Causes Control"},{"key":"ref52","doi-asserted-by":"publisher","first-page":"101","DOI":"10.3109\/10408440903352826","article-title":"Meta-analyses of occupational exposure as a painter and lung and bladder cancer morbidity and mortality 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J Cancer"},{"key":"ref59","doi-asserted-by":"publisher","first-page":"500","DOI":"10.1016\/j.scitotenv.2005.10.010","article-title":"Air pollution and lung cancer risks in China--a meta-analysis","volume":"366","author":"Zhao","year":"2006","journal-title":"Sci Total Environ"},{"key":"ref60","doi-asserted-by":"publisher","first-page":"1228","DOI":"10.1183\/09031936.00099511","article-title":"Lung cancer risk and solid fuel smoke exposure: a systematic review and meta-analysis","volume":"40","author":"Kurmi","year":"2012","journal-title":"Eur Respir J"},{"key":"ref61","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1002\/ajim.23093","article-title":"Occupational exposure to formaldehyde and risk of lung cancer: a systematic review and meta-analysis","volume":"63","author":"Kwak","year":"2020","journal-title":"Am J Ind Med"},{"key":"ref62","doi-asserted-by":"publisher","first-page":"1137","DOI":"10.1186\/s12889-016-3791-5","article-title":"Occupational exposure to silica dust and risk of lung cancer: an updated meta-analysis of epidemiological studies","volume":"16","author":"Poinen-Rughooputh","year":"2016","journal-title":"BMC Public Health"},{"key":"ref63","doi-asserted-by":"publisher","first-page":"1270608","DOI":"10.1155\/2017\/1270608","article-title":"Occupational exposure to talc increases the risk of lung Cancer: a Meta-analysis of occupational cohort studies","volume":"2017","author":"Chang","year":"2017","journal-title":"Can Respir J"},{"key":"ref64","doi-asserted-by":"publisher","first-page":"1457","DOI":"10.3390\/ijerph17041457","article-title":"Residential radon and histological types of lung cancer: a meta-analysis of case\u2013control studies","volume":"17","author":"Li","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"ref65","doi-asserted-by":"publisher","first-page":"S7","DOI":"10.4103\/0973-1482.168965","article-title":"The relationship of indoor coal use and environmental tobacco smoke exposure with lung cancer in 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