Lung cancer isone of the most common and dreaded malignancy worldwide and is a leading causeof cancer-related deaths.(1) It isresponsible for more cancer-related deaths than breast cancer, colon cancer andprostate cancer combined.(2,3) Predominantly a disease of the elderly(4)the average age of newly diagnosed lung cancerpatients is around 60 years.
(5)It is slightly more common in males than in females(.6) although the trendappears to be changing now The male and female ratio of >6:1 in1973 has changed to 1.5:1 in 2008.(7) Although smoking remains theprincipal cause of lung cancer worldwide(8)only 10% of smokers develop lung cancer, thus genetic, occupational and dietaryrisk factors also appear to play an important role in its pathogenesis.(9) The other riskfactors include, passive smoking, exposure to environmental pollutants, occupationalexposure to chemicals and to the natural radioactive gas radon.
(10)Genetic predisposition, especially polymorphisms of the tumor suppressor genesand the allelic variants of the genes involved in detoxification, areimplicated in the susceptibility to the disease.(11) Despite advances in treatment, theprognosis remains poor, with only 15% of patients surviving > 5 yr from timeof diagnosis. For patients with stage IV (metastatic) disease, the 5-yr overallsurvival rate is < 1%.
Improving survival requires focusing attention onsmoking cessation, early detection, and research into the genetic profile oflung tumors and developing novel forms of therapy.(12) Glycated hemoglobin (HbA1c) is formedby a posttranslational, non-enzymatic, substrate-concentration dependentirreversible process of combination of aldehyde group of glucose and otherhexoses with the amino-terminal valine of the ?-chain of hemoglobin(13) and reflects the 3month average endogenous exposure to glucose including postprandial spikes inthe blood glucose level, and has low intra individual variability, particularlyin persons without diabetes. These characteristics contribute to thesuperiority of glycated hemoglobin over fasting glucose for long-termmacrovascular risk stratification. Theestimation of HbA1c has provided a dependable method of assessing glycemiccontrol in diabetics. This method has been extensively validated in diabeticsas a reliable, inexpensive and non-manipulable parameter.
(13) A large number of kinetic studies haverevealed that glycemia in the recent past influences the HbA1c values more thanthe remote past. Thus, mean blood glucose of past 1 month, 2 months and 3months contributes 50%, 40% and 10% respectively to the final result.(14) There are only a very few relevantepidemiological studies regarding association of serum HbA1c and risk ofdevelopment of lung cancers. In view of the above, this study was planned toassess serum HbA1c levels in lung cancer patients and to compare it with the levels of HbA1c in normalpopulation.