Early-life undernutrition, immune dysregulation, and cancer incidence in later life: a national life-course analysis from the China health and retirement longitudinal study.

No significant interactions by sex or rural/urban residence were detected (p > 0.05), whereas interaction tests indicated marginal significance for age (p = 0.042) and comorbidity status (p = 0.048).

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Fixed-effects pooling of the two cohorts produced summary estimates that remained highly significant with narrow confidence intervals and minimal between-study heterogeneity (I2 ≤ 12%), indicating excellent concordance. 4 Discussion The study based on a representative sample from CHARLS reveals that early-life undernutrition, defined by the joint consideration of historical records and birth-year criteria, is a considerable public health concern among middle-aged and older adults in China.

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Nevertheless, the marginally significant interactions for age suggest a possible cumulative burden effect, whereby the long-term impact of early-life famine emerges more prominently at older ages.

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