Fig. 2: Association of thymic health with long-term mortality.

a, Overview of the NLST. Data are sorted by ascending thymic health where each column represents one patient. Thymic health is categorized into low, average and high based on the bottom 25% (blue), middle 50% (orange) and top 25% (red) of the population. The fractional left split of the NLST represents patients who were defined as having low thymic health through automatic quality control. b, Associations between thymic health and sex (n = 25,031) in the NLST, across age groups in years (n = 25,031) and body mass categories (n = 24,948, missingness n = 83). ^***P < 2 × 10⁻¹⁶; NS, not significant with P = 0.2505. c, Kaplan–Meier plots for overall survival outcomes in the NLST across thymic health categories. The inset in the plot shows the same data on an expanded y axis. Unadjusted HRs are shown on the bottom left. d, HR for thymic health categories adjusted for pack-years and smoking status and stratified by sex and age binned at 5 years. e–g, HRs of all-cause death for participants in the NLST, using continuous age as the time scale to account for potential residual confounding by age (n = 25,027; missingness n = 4) adjusted for pack-years and smoking status and stratified by sex (e); adjusted for the shown clinical and epidemiological covariates and stratified by sex and age binned at 5 years (n = 24,597; missingness n = 434) (f); adjusted for the shown clinical and epidemiological covariates and stratified by sex and age binned at 5 years in the subgroup of the NLST in which participants with a history of cancer (n = 575), childhood or adult asthma, diabetes, asbestosis, bronchiectasis, lung fibrosis, sarcoidosis, silicosis or tuberculosis (n = 5,500) were excluded from the analysis (n = 18,565; missingness n = 54) (g). COPD, chronic obstructive pulmonary disease.