Associations of biological aging with the morbidity and all-cause mortality of patients with lung cancer

Accelerated biological aging has been suggested to be an important risk factor for age-related diseases, but its role in the development of lung cancer is still unclear. The aim of this study was to analyze the relationship between biological aging and lung cancer and its impact on mortality using the NHANES database. We calculated the chronological age-adjusted biological age of 40,765 participants in the U.S. National Health and Nutrition Examination Survey (NHANES) database from 2001 to 2020 using the phenotypic age (PhenoAge) method. Both cross-sectional and longitudinal analyses were performed to assess the associations of biological aging with lung cancer prevalence and mortality in the cohort. Logistic regression and Cox proportional hazards models were used to examine these associations. Sensitivity analysis was conducted using propensity score matching (PSM). Our results indicated that accelerated biological aging was positively associated with an increased risk of developing lung cancer. Individuals with accelerated aging had a greater risk of developing lung cancer than nonaccelerated aging individuals did, with odds ratios of 2.60 (full adjustment 95% CI 1.59-4.22, p < 0.001). According to the fully adjusted models, participants in the Q4 subgroup had a 334% greater risk of developing lung cancer. In addition, accelerated biological aging was positively associated with all-cause mortality among individuals with lung cancer. Our study demonstrated that the identification of individuals with accelerated biological aging represents a promising strategy for the identification of populations at elevated risk of developing lung cancer and serves as an independent predictor of mortality in this population.