COVID-19 impacts on lung cancer diagnosis, management and timeliness in Victoria, Australia: A population based observational study

Objectives : To describe impact of COVID-19 on lung cancer incidence, stage at diagnosis, treatment utilisation and timeliness of care in Victoria, Australia. Design : Retrospective study using population wide Victorian Cancer Registry data and clinical data from the Victorian Lung Cancer Registry, comparing data pre-COVID (2019 and Q1 of 2020) with the COVID era (April 2020-31/12/2020). Setting and participants : Population wide data on lung cancer diagnoses diagnosed in 2019 and 2020 in Victoria, and 4485 cases with additional clinical data. Result(s): Compared In the COVID-era, 177 fewer males (-12%) and 4 fewer females (-0.3%) were diagnosed with lung cancer. Stage at diagnoses for NSCLC was higher on average in Q2 2020 and was similar to the pre-COVID distribution in Q2 and Q4. No changes were detected in the stage distribution for SCLC. The proportion of patients whose time from referral to diagnosis was >=28 d decreased with increasing volume of referrals but was higher in the COVID era (74.6%) compared with the pre-COVID era (67.5%), not caused by a decrease in volume. The proportion of patients receiving any anti-cancer treatment reduced slightly from 84% in the pre-COVID era to 81% in the COVID era ( p = 0.022). Time from diagnosis to treatment (>=14 d;37.3% of patients on average) was not associated with volume of new diagnoses, nor did change in the COVID-era ( p = 0.13). The proportion of NSCLC patients who received guideline concordance treatment did not differ between pre-COVID (83.1%) and the COVID era (81.7%;p = 0.31).

COVID-19 impacts on lung cancer diagnosis, management and timeliness in Victoria, Australia

Objectives: To describe impact of COVID-19 on lung cancer incidence, stage at diagnosis, treatment utilisation and timeliness of care in Victoria, Australia. Design(s): Retrospective study using population wide Victorian Cancer Registry data and clinical data from theVictorian Lung Cancer Registry, comparing data pre-COVID (2019 andQ1 of 2020) with theCOVID era (April 2020 onwards). Setting(s): Population wide data on lung cancer diagnoses diagnosed in 2019 and 2020 in Victoria, and 4,485 caseswith additional clinical data. Preliminary results: In the COVID-era, 177 fewer males (-12%) and four fewer females (-0.3%) were diagnosed with lung cancer. Clinical stage at diagnoses for NSCLC was higher on average in Q2 2020 and was similar to the pre-COVID distribution in Q2 and Q4. No changes were detected in the stage distribution for SCLC. The proportion of patients whose time from referral to diagnosis was <=28d decreased with increasing with volume of referrals but was higher in the COVID era (74.6%) compared with the pre-COVID era (67.5%), not caused by a decrease in volume. The proportion of patients receiving any anticancer treatment reduced slightly from 84% in the pre-COVID era to 81% in the COVID era (p = 0.022). Time from diagnosis to treatment (<=14d;37.3% of patients on average) was not associated with volume of new diagnoses, nor did change in the COVID-era (p = 0.13). The proportion ofNSCLCpatientswhoreceived guideline concordance treatment did not differ between pre-COVID (83.1%) and the COVID era (81.7%;p = 0.31). Conclusion(s): Less males were diagnosed with lung cancer in theCOVIDera. Although the health care system in Victoria had many disruptions following COVID restrictions, no negative impact on treatment utilisation nor timeliness was observed. In fact, timeliness from referral to diagnoses improved in the COVID era.