BRIEF REPORT
Prevalence of low body mass index among newly diagnosed
lung cancer patients in North India and its association with
smoking status
Navneet Singh, Ashutosh N. Aggarwal, Dheeraj Gupta & Digambar Behera
Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
Keywords
Body mass index; heavy smoking; India; lung
cancer; smoking index.
Correspondence
Navneet Singh, Department of Pulmonary
Medicine, Postgraduate Institute of Medical
Education and Research (PGIMER), Sector 12,
Chandigarh 160012, India.
Tel: +91 172 2756826
Fax: +91 172 2747759
Email: navneetchd@yahoo.com
Received: 4 November 2010;
accepted 23 November 2010.
doi: 10.1111/j.1759-7714.2010.00037.x
Abstract
There is limited data from South Asia on the prevalence of low body mass index
(BMI) among newly diagnosed lung cancer patients at presentation and its associa-
tion with smoking status. A retrospective analysis of a prospective cohort of newly
diagnosed lung cancer patients is presented here. Patients were categorized as
normal/overweight (BMI 18.50 kg/m
2
; group I), mild/moderately underweight
(BMI = 16.00–18.49 kg/m
2
; group II) or severely underweight (BMI < 16.0 kg/m
2
;
group III). Smoking status was assessed using the smoking index (SI; product of
number of bidis/cigarettes smoked per day with number of years smoked). Based on
the SI, patients were categorized as never-smokers, light/moderate smokers [SI = 1–
300] and heavy smokers [SI 301]. A low BMI was present in 155 (44.3%) patients.
Compared to group I, patients in groups II and III had higher percentages of
men and current/ex-smokers. On univariate logistic regression analysis (LRA),
SI = 1–300 [odds ratio (OR) = 2.75; 95% confidence intervals (CI) = 1.27–5.97] and
SI 301 [OR = 4.57; 95% CI = 2.20–9.49] were associated with higher odds of the
presence of low BMI among non-small cell lung cancer (NSCLC) patients while
female sex had lower odds [OR = 0.34; 95% CI = 0.16–0.72]. On multivariate LRA,
only SI 301 [OR = 3.74; 95% CI = 1.59–8.80] had a significant association with
occurrence of low BMI. Low BMI is common among newly diagnosed lung cancer
patients in North India. Heavy smoking is independently associated with presence of
low BMI at presentation among NSCLC patients.
Introduction
Smoking of tobacco remains the most important risk factor
for the development of lung cancer.
1
The majority of patients
with lung cancer present with advanced stage at the time of
diagnosis.
2,3
Advanced cancer is associated with weight loss
and cachexia. Weight loss and cachexia are also common
among patients with chronic obstructive pulmonary disease
(COPD), another disease associated with tobacco smoking.
4
There is a paucity of data from South Asia and the Indian sub-
continent on the influence of smoking on body mass index
(BMI) among newly diagnosed lung cancer patients. The
authors postulated that smoking status could influence BMI
in newly diagnosed lung cancer patients and that this associa-
tion could be quantitative. The current study was undertaken
in an attempt to evaluate the prevalence of low BMI and its
association with smoking status among newly diagnosed lung
cancer patients.
Methods
Study population and design
This was a retrospective analysis of prospectively collected
data of a cohort of lung cancer patients presenting to the
authors’ institute – an apex super speciality government
health care institute in North India that caters to patients
referred from primary, secondary and other tertiary health
care institutes (including medical schools) located in several
Indian states. Consecutive newly diagnosed patients with
Thoracic Cancer ISSN 1759-7706
27 Thoracic Cancer 2 (2011) 27–31 © Tianjin Lung Cancer Institute and Blackwell Publishing Asia Pty. Ltd