Journal Article

Diagnostic and therapeutic delays in lung cancer during the COVID-19 pandemic: a single center experience at a German Cancer center

Mack, Elisabeth K. M., Faoro, Charis, Middeke, Martin, Kirschbaum, Andreas, Holland, Angélique, Tarawneh, Thomas S., Neubauer, Andreas

2024

Overview

Background The COVID-19 pandemic has had negative drawbacks on the healthcare system worldwide and on individuals other than those directly affected by the virus. Delays in cancer therapy and diagnosis have been reported in the literature. We hypothesized similar effects on patients with lung cancer at our center. Methods We retrospectively analyzed data of patients referred to our center with newly diagnosed lung cancer from 2018 to 2022. We considered distribution of UICC Stages and time from case presentation in our multidisciplinary tumor board or from therapeutic indication from treating physician to therapy initiation (surgery, systemic therapies and radiation) to define delays in diagnosis and treatment. Results 1020 patients with newly diagnosed lung cancer were referred to our center from 2018 to 2022, with a median of 206 cases yearly (range: 200–208). Cases with Stage IV in 2020–2022 were significantly higher than in 2018–2019 (57% vs. 46%, p  = 0,001). 228 operative resections took place between 2018 and 2022, 100 from January 2018 to February 2020 and 128 from March 2020 to December 2022. Median time from presentation in our tumor board to resection was also significantly longer after the beginning of the pandemic than before (22 days vs. 15,5 days, p  = 0,013). No significant delays were observed for administration of systemic treatment and initiation of radiation. Conclusions During the pandemic higher disease stages were reported for patients with lung cancer, yet there were no clinically relevant delays in treatment. In the context of the post-covid era new diagnostic strategies are necessary to facilitate early diagnosis of lung cancer. Despite the pandemic, for patients with suspicious symptoms prompt access to healthcare facilities is essential for early diagnosis.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Adult / Aged / Aged, 80 and over / Cancer / Cancer Care Facilities / Cancer staging / Cancer therapies / Care and treatment / COVID-19 / COVID-19 - epidemiology / Critical Care Medicine / Delayed Diagnosis / Diagnosis / Epidemics / Female / Germany / Germany - epidemiology / Health aspects / Health care / Health care access / Histology / Humans / Infections / Influence / Intensive / Internal Medicine / Lung cancer / Lung diseases / Lung Neoplasms - diagnosis / Lung Neoplasms - therapy / Male / Mann-Whitney U test / Medical diagnosis / Medicine / Medicine & Public Health / Middle Aged / Mortality / Neoplasm Staging / Pandemics / Patient outcomes / Patients / Pneumology/Respiratory System / Radiation / Radiation therapy / Radiotherapy / Respiratory agents / Retrospective Studies / SARS-CoV-2 / Screening / Severe acute respiratory syndrome coronavirus 2 / Software / Surgery / Surgical outcomes / The Impact of COVID-19 on Lung Cancer Patients / Time-to-Treatment - statistics & numerical data / Tumor staging / Tumors