Evidence mapPaperPMID 42573708Full record

ArticleClinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico2026

Sex-specific associations of the bilirubin-to-albumin ratio with lung cancer risk: evidence from Cox regression and causal survival forest analysis.

Jong Won Shin, Yon Ho Jee, Mikyung Ryu

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Article in Clinical & translational oncology : official publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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3 authors.

Jong Won Shin *Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Ulsan, Seoul, 05505, Republic of Korea. jongwon_shin@amc.seoul.kr.ORCID http://orcid.org/0009-0003-8587-1445
Yon Ho Jee *Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA.
Mikyung RyuGraduate School of Alternative Medicine, Kyonggi University (Seoul Campus), 24, Kyonggidae-Ro 9-Gil, Seodaemun-Gu, Seoul, 03746, Republic of Korea.

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6 · The paper itself

Abstract

backgroundThe bilirubin-to-albumin (BA) ratio may reflect the balance between circulating bilirubin and albumin-related binding capacity, but its association with lung cancer risk remains unclear.

methodsWe analyzed data from the Korean Cancer Prevention Study-II, a nationwide prospective cohort. After excluding participants with baseline cancer or missing key variables, 81,746 men and 49,421 women were included. Total, indirect, and direct BA ratios were calculated and standardized per 1-standard deviation increase. Sex-specific associations with lung cancer risk were assessed using Cox proportional hazards models, quartile analyses, restricted cubic splines, and causal survival forest models.

resultsIn Cox models, higher total and direct BA ratios were inversely associated with lung cancer risk in men, whereas higher total and indirect BA ratios were positively associated with risk in women. Restricted cubic spline analyses supported inverse dose-response patterns for total and direct BA ratios in men. Causal survival forest analyses showed statistically significant positive average treatment effects for lung cancer-free survival probability only in men across 5-, 10-, and 13-year horizons.

conclusionsBA ratio showed sex-specific associations with lung cancer risk, with more consistent inverse associations among men.

Indexed as

AlbuminBilirubinLung neoplasmsMachine learningSex factors

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.