The impact of the COVID-19 pandemic on delay in diagnosis and management of lung cancer in developing countries

ABSTRACT

Introduction: The COVID-19 pandemic has caused an overload within health care structures in Tunisia, impacting negatively on the management of other pathologies. In this study, we estimated the impact of the COVID-19 pandemic on delay in diagnosis and management of lung cancer in a Department of Pulmonology in Tunisia. Method(s) A retrospective study including patients with lung cancer managed between January 2019 and December 2021 in the Pulmonology IV Department of Abderrahmane Mami Hospital. The patients were divided into two groups Group 1(G1)(n= 59) included patients diagnosed before Covid-19 pandemic (January/December 2019). Group 2 (G2) (n =71) diagnosed during the Covid-19 pandemic (march 2020/December 2021). Result(s) One hundred and thirty male patients were included with an average age of 60.8 years. The mean delay between the onset of symptoms and the first consultation was 43.27 days in G1 versus 39.92 in G2 . The mean delay between first consultation and the histological diagnosis was significantly longer in G2 (34.3 days vs 31.85 days in G1;p = 0.037). The most common histological type in both groups was adenocarcinoma. Sixty point six percent of patients of G2 were diagnosed at metastatic stage (vs 47.5 % in G1 ). The mean delay between histological diagnosis and initiation of specific treatment was significantly longer in G2 (60.34 days vs 41.67 days in G1 ;p = 0.014). Conclusion(s) The study demonstrates the significant impact of COVID-19 on diagnostic and therapeutic delays for lung cancer patients in our department. A specific care pathway needs to be created in order to ensure treatment within the optimal deadlines.