The impact of the COVID-19 pandemic on the diagnosis, treatment, and
outcomes of lung cancer: A nationwide study
Abstract
The COVID-19 pandemic disrupted healthcare systems globally,
significantly impacting the continuum of care for diseases such as lung
cancer (LC), which is the deadliest cancer worldwide. Preliminary
evidence suggests shifts toward more advanced LC stages at diagnosis
during the pandemic, with potential changes in treatment and survival
outcomes. This study provides a comprehensive nationwide analysis of
these trends.This retrospective cohort study analyzes data from the
November 2022 update of the Surveillance, Epidemiology, and End Results
(SEER) database, focusing on LC patients diagnosed between 2018 and
2020. The analysis compares diagnostic stages, treatment delays, and
survival outcomes before and during the pandemic, employing logistic
regression, Cox proportional hazards, and Fine-Gray competing risks
regression models.The study included 106,226 LC patients, with findings
indicating more advanced stages at diagnosis and shorter treatment
delays in 2020 compared to the previous two years. The overall incidence
of LC decreased significantly in 2020, with variations across different
demographics and histologic subtypes. Despite these changes, no
significant differences were observed in overall survival (OS) or lung
cancer-specific survival (LC-SS) between the groups. The COVID-19
pandemic has led to later-stage LC diagnoses and somewhat quicker
initiation of treatment, although it did not significantly impact
short-term survival outcomes. These findings underscore the resilience
of LC management under pandemic constraints and highlight the need for
ongoing vigilance to mitigate long-term impacts on patient care and
outcomes.