Prevalence and Determinants of Chronic Respiratory Diseases in Patients with Lung Cancer in a Tertiary Care Setting in India Chronic Respiratory Diseases in Lung Cancer

Abstract

Background: Chronic respiratory diseases (CRDs) frequently coexist with lung cancer and may adversely influence clinical outcomes. However, data from India on the prevalence and determinants of CRDs among lung cancer patients remain limited.
Objectives: To estimate the prevalence of CRDs and identify associated factors among patients with lung malignancies in a tertiary care setting.
Methods: A retrospective observational study was conducted among 192 adult patients with histopathologically confirmed lung cancer at a tertiary care hospital in Kerala, India (June 2020–June 2022). Data on sociodemographic factors, behavioural exposures, comorbidities, and CRDs were extracted from medical records. CRDs included chronic obstructive pulmonary disease (COPD), asthma, interstitial lung disease (ILD), and prior tuberculosis (TB). Associations were assessed using χ²/Fisher’s exact test and log-binomial regression. Adjusted prevalence ratios (APR) with 95% confidence intervals (CI) were reported.
Results: The prevalence of CRDs was 19.4%, with COPD being the most common (15.6%), followed by asthma (5.2%). The majority of patients were male (75%) and aged ≥60 years. Multivariable analysis showed that age 70-79 years (APR=8.05; 95% CI: 1.09-59.27), ≥80 years (APR=10.07; 95% CI: 1.29-78.25), hypertension (APR=1.96; 95% CI: 1.18-3.27), and prior TB (APR=2.85; 95% CI: 1.75-4.64) were independently associated with CRDs. Smoking and diabetes were not statistically significant after adjustment.
Conclusions: Nearly one in five lung cancer patients had coexisting CRDs, predominantly COPD. Increasing age, hypertension, and prior TB were key determinants. Integrated screening and management of CRDs in lung cancer care may improve clinical outcomes in resource-limited settings.