Abstract
IntroductionCOVID-19 has disrupted the global health care system since March 2020. Lung cancer (LC) patients (pts) represent a vulnerable population highly affected by the pandemic. This multicenter Italian study aimed to evaluate whether the COVID-19 outbreak had an impact on access to cancer diagnosis and treatment of LC pts compared with pre-pandemic time.MethodsConsecutive newly diagnosed LC pts referred to 25 Italian Oncology Departments between March and December 2020 were included. Access rate and temporal intervals between date of symptoms onset and diagnostic and therapeutic services were compared with the same period in 2019. Differences between the 2 years were analyzed using the chi-square test for categorical variables and the Mann–Whitney U test for continuous variables.ResultsA slight reduction (−6.9%) in newly diagnosed LC cases was observed in 2020 compared with 2019 (1523 versus 1637, P = 0.09). Newly diagnosed LC pts in 2020 were more likely to be diagnosed with stage IV disease (P < 0.01) and to be current smokers (someone who has smoked more than 100 cigarettes, including hand-rolled cigarettes, cigars, cigarillos, in their lifetime and has smoked in the last 28 days) (P < 0.01). The drop in terms of new diagnoses was greater in the lockdown period (percentage drop −12% versus −3.2%) compared with the other months included. More LC pts were referred to a low/medium volume hospital in 2020 compared with 2019 (P = 0.01). No differences emerged in terms of interval between symptoms onset and radiological diagnosis (P = 0.94), symptoms onset and cytohistological diagnosis (P = 0.92), symptoms onset and treatment start (P = 0.40), and treatment start and first radiological revaluation (P = 0.36).ConclusionsOur study pointed out a reduction of new diagnoses with a shift towards higher stage at diagnosis for LC pts in 2020. Despite this, the measures adopted by Italian Oncology Departments ensured the maintenance of the diagnostic-therapeutic pathways of LC pts.
Highlights
COVID-19 has disrupted the global health care system since March 2020
In this study, using datasets from different Italian oncologic departments, we aimed to assess whether the COVID19 outbreak had an impact on new diagnoses of Lung cancer (LC)
We evaluated access to diagnosis and treatment of a cohort of newly diagnosed LC pts during the pandemic and compared it with the pre-pandemic period, to provide a real-world picture of efficacy of the health care system response to the COVID-19
Summary
COVID-19 has disrupted the global health care system since March 2020. Lung cancer (LC) patients (pts) represent a vulnerable population highly affected by the pandemic. This multicenter Italian study aimed to evaluate whether the COVID-19 outbreak had an impact on access to cancer diagnosis and treatment of LC pts compared with pre-pandemic time. In the setting of cancer pts care, many efforts have been placed in order to ensure high-quality standards for diagnostic-therapeutic pathways, according to the guidelines from the major scientific societies.[4,5]. Undiagnosed cancer diseases are expected to emerge at a more advanced stage and with a worst prognosis,[11] including that a significant delay in diagnosis and access to treatment may result in suboptimal therapeutic care of cancer pts and in increased mortality.[12,13] Recent studies have pointed out a remarkable reduction of new cancer diagnoses in Europe and USA during the pandemic period.[9,10] Undiagnosed cancer diseases are expected to emerge at a more advanced stage and with a worst prognosis,[11] including that a significant delay in diagnosis and access to treatment may result in suboptimal therapeutic care of cancer pts and in increased mortality.[12,13]
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