Association between the neutrophil-to-lymphocyte ratio and cancer in adults from NHANES 2005-2018: a cross-sectional study

Abstract

Inflammation plays a crucial role in cancer development. The neutrophil-to-lymphocyte ratio (NLR), a measure of inflammation, is obtained from a complete blood count. However, little is known about the association between NLR and cancer in the general adult population in the United States. This study aimed to evaluate whether NLR is associated with cancer in American adults. This retrospective cross-sectional study included 28,016 adult participants from the National Health and Nutrition Examination Survey (NHANES) dataset spanning 2005 to 2018. Data on demographics (age, sex, race, marital status, Poverty-Income Ratio, education level), lifestyle factors (smoking, alcohol consumption, body mass index), medical conditions (hypertension, diabetes, cardiovascular disease), and laboratory parameters (hemoglobin, platelet count, alanine aminotransferase, creatinine, albumin, and lactate dehydrogenase), were collected. Logistic regression analysis was used to investigate the research objectives. Of the total 28,016 participants, 2639 had cancer. The mean age was 49.6 ± 17.6 years, and 50% were male. A positive association between NLR and cancer risk was observed after multivariate adjustment (OR = 1.20, 95% confidence interval (CI) = 1.05-1.36, p = 0.006). Similar patterns were observed in subgroup analyses (all p-values for interaction > 0.05). A higher NLR was directly correlated with an increased risk of developing cancer in adults.

Keywords: Cancer; Cross-sectional study; Lymphocyte; NHANES; Neutrophil.

Fig. 1

The flow chart of the study.

Fig. 2

Adjusted Relationship between NLR and Cancer Odds Ratio. Solid and dashed lines represent the predicted value and 95% confidence intervals. They were adjusted for age, sex, race, marry, PIR, education, smoke, alcohol drinking status, body mass index, hypertension, diabetes, cardiovascular disease, hemoglobin, platelet, alanine aminotransferase, creatinine, albumin and lactate dehydrogenase levels.

Fig. 3

The relationship between NLR and cancer according to basic features. Except for the stratification component itself, each stratification factor was adjusted for all other variables (age, sex, race, marry, PIR, education, smoke, alcohol drinking status, body mass index, hypertension, diabetes, cardiovascular disease, hemoglobin, platelet, creatinine, alanine aminotransferase, albumin and lactate dehydrogenase levels).