The Longitudinal Impact of COVID-19 on the Diagnosis and Treatment of Lung Cancer at a Canadian Academic Centre: A Retrospective Chart Review

ABSTRACT

Introduction: The COVID-19 pandemic presented many challenges to the delivery of healthcare, especially for those with lung disease.Our group recently reported that the rate of new lung cancer diagnoses declined by 35% during the first year of the COVID-19 pandemic (year 2020). The objective of the present study is to evaluate the changes in new lung cancer (LC) diagnoses during the 2 years of the pandemic compared to the pre-pandemic era, and its subsequent effect on survival of lung cancer patients. Methods: This is a retrospective chart review study including patients diagnosed with lung cancer between March 1st 2019 and February 28th 2022 at the Peter Brojde Lung Cancer Centre at the Jewish General Hospital, Montreal. We compared 3 cohorts Cohort 1 (C1) March 1, 2019 to February 29, 2020 (pre-COVID). Cohort 2 (C2) March 1, 2020 to February 28, 2021 (1st year of COVID). Cohort 3 (C3) March 1, 2021 to February 28, 2022 (2nd year of COVID;reporting for 11 months). Results: A total of 404 patients were diagnosed with lung cancer throughout the three-year study 130 in C1, 103 in C2 and 171 in C3. Using C1 as a baseline, we found that new diagnoses of LC declined by 21% in C2, and rose by 32% in C3. The incidence of metastatic lung cancer increased by 41% in 2021 compared to 2019 (96 cases vs 68 cases) and by 63% compared to 2020 (96 cases vs 59 cases). Of the 59 metastatic LC patients diagnosed in 2020, 31 (52%) died, whereas 28/68 (41%) died in 2019. The median survival for metastatic LC in the first year of the pandemic decreased compared to pre-COVID year (14.5 vs 8.7 months) (Table 1). Statistical significance has not been reached as follow-up time was not long enough for year 2020 (p=0.58). Conclusions: The present study represents interim data of our ongoing effort to evaluate the effect of the COVID-19 pandemic on our lung cancer patients. The pandemic has led to a significant decline in LC diagnoses in the first year, and a subsequent increase in diagnoses during the 2nd year. Unfortunately, these changes resulted in a trend towards decreased survival for our metastatic LC patients. The final survival analysis will require longer follow-ups and this data will be presented at the meeting. [Formula presented] Keywords COVID-19, Retrospective, Survival