Telomeres are DNA structures at the end of chromosomes that protect them from damage and instability.1 In most cells, telomeres shorten with each cell cycle; thus, telomere shortening indicates the proliferative history of the cell.2 When telomeres become critically short, cells enter senescence cell cycle arrest or undergo apoptosis.2 Telomere attrition is largely associated with age and genetic determinants but is modulated by host-related genetics (such as male sex) as well as lifestyle factors (eg, smoking, physical activity, and stress).3 Leukocyte telomere length (LTL) serves as a biomarker for the telomere length of the individual organism, and shortening of LTL has been associated with a broad range of pathologies, including lung, liver, hematologic, and cardiovascular diseases, as well as multiple cancer entities.4-6 Despite that, to our knowledge, the prognostic value of LTL remains to be comprehensively characterized,7 as most studies have either relatively small sample sizes, short follow-up duration, or insufficient power to detect clinically meaningful associations.