Lung cancer referrals: The impact of the coronavirus pandemic

ABSTRACT

Introduction: Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has been declared a global pandemic.1 A national lock-down was announced in the UK from 23rd March 2020, with a public health campaign encouraging patients to stay home. Healthcare services, including the NHS, had to urgently adapt to the demands of COVID-19, with changes in primary and secondary care. At our hospital trust we have reviewed the referrals to our lung cancer services during the pandemic. Suspected lung cancers in the community are referred using the cancer 2-week pathway. Survival estimates for lung cancer are poor compared to most other primary cancers and NICE advocates for quick referral to a specialist for patients whom lung cancer is suspected 2. We have looked at the impact of the pandemic on the referrals to our services. Method: We have reviewed the referrals to lung cancer services, via the lung cancer 2-week pathway at our hosptial trust, between the same periods in 2019 and 2020. Results: There has been a noticeable reduction in the number of referrals to the lung cancer services from the 23rd March, in comparison to same period in 2019 (see graph 1). Between weeks 13 and 19 of 2020 there was a 56.85% reduction in the number of referrals made compared to 2019. Conclusion: There are several likely reasons for the reduction in referral rate shown, including the nationwide advice to 'stay home to protect the NHS', changes to service provision and alterations to clinical set-ups. Timely referral of patients to lung cancer services and prompt diagnosis are essential, directly relating to lung cancer outcomes. We all, therfore, have a responsibility to ensure we learn from the COVID-19 pandemic, to help develop robust services, on top of appropriate clinical awareness, ensuring essential medical services can be provided irrespective of other pressures on the NHS.