Impact of the COVID-19 pandemic on lung cancer diagnosis in the region of Marrakech-Safi, Morocco

Abstract

Background: The dreadful consequences of the COVID-19 pandemic put an unprecedented pressure on health-care services in Morocco. Lung cancer (LC) patients represent a vulnerable population highly affected by the pandemic. Studies on lung cancer diagnosis during an epidemic are lacking. We analyzed the impact of COVID-19 on lung cancer diagnosis in the region of Marrakech-Safi where lung cancer incidence continues to rise. Materials and Methods: We compared the clinical features of newly diagnosed lung cancer cases in the Mohammed VI University Hospital Center between March and December 2020 with lung cancer cases diagnosed during the same period in the past 3 years and the year after. Results: A total of 352 patients were diagnosed with lung cancer from March through December, 2017–2021. During the pandemic, the number of lung cancer hospitalization dropped by 36% from the previous years, moreover the number of bronchoscopies and other biopsies performed decreased significantly in 2020 (p < 0.000).Lung cancer patients in Group2 had a significant longer pre-hospital delay with a mean of 7, 02±2,06 months and higher performance status score 3-4 (64,6%) compared to the other Groups 1,3 (p < 0.000).In the second and third groups more lung cancer patients seems to be exposed to second-hand smoke comparing to the first group with (27,4%) in 2017-2019 vs (52,1%) and (69,2%) in 2020 and 2021 respectively(p < 0.000). However no differences concerning tumor staging has been described between the 3 groups with most patients being classified as stage IVA-IVB through all the years (2017-2019: 73,9% vs. 2020: 85,4% vs 2021: 80,8%, p=0,151). Conclusion: The COVID-19 pandemic was responsible of a significant decrease in newly diagnosed LC cases with less bronchoscopies and biopsies being performed. No significant difference has been noted regarding tumor staging but LC patients seemed to have higher performance status score in 2020.