COVID Has Led to a Drop in Lung Cancer Diagnosis, More Deaths

By Megan Brooks

February 02, 2021

NEW YORK (Reuters Health) - A study from Spain demonstrates the clear and significant negative impact the COVID-19 pandemic is having on lung cancer diagnosis and outcomes.

"The COVID-19 pandemic is likely to last for a very long period of time, so we have to make a special effort for ensuring the cancer diagnosis and treatment of our patients," Dr. Roxana Reyes said during a press briefing at International Association for the Study of Lung Cancer (IASLC) virtual World Conference on Lung Cancer (WCLC).

Dr. Reyes, with the Thoracic Oncology Group at the Hospital Clinic de Barcelona, and colleagues, analyzed data of new cases of lung cancer diagnosed in from January to June 2019 (pre-COVID) and the same time frame one year later during COVID-19.

They found that 100 of the 162 patients with newly-diagnosed lung cancer were diagnosed in the pre-COVID period (62 during COVID) - a 38% decline in new lung cancer diagnoses during the pandemic.

By histologic subtype, 110 patients had non-small cell lung cancer (NSCLC) and 52 had SCLC.

There was a 36% drop in new NSCLC diagnoses during COVID (vs before) and NSCLC cases that were diagnosed during COVID were more symptomatic and severe.

There was a 42% drop in new SCLC diagnoses during COVID (vs before), but no increase in severe disease.

There was also an increase in 30-day lung cancer-associated deaths during COVID. For NSCLC, 30-day mortality rate increased from 25% before COVID to 49% during COVID. For SCLC, 30-day mortality increased from 18% pre-pandemic to 32% during COVID.

"Strategies for maintaining cancer diagnosis need to be implemented during the COVID-19 pandemic," Dr. Reyes told the briefing.

Speaking at the briefing, patient advocate and lung cancer survivor Ivy Elkins, member of the IASLC Lung Cancer News (ILCN) Editorial Group, said, "As someone who encourages other patients to seek out of medical attention at the first sign of any concerning symptoms, it's extremely worrisome to me that COVID-19 has led to delay but cancer diagnoses with increasing numbers of patients presenting with more advanced disease and higher symptom burden."

"It's completely understandable that patients are concerned about seeking treatment due to fear of contracting COVID and bringing it home to their loved ones. However, this delay can make the difference between life and death," said Elkins.

"Imagine," she added, "that you have a cough that just won't go away. You've been tested for COVID and you're relieved that you are negative. The COVID-19 pandemic is booming and since the cause of your cough is not COVID, you might decide that it just isn't that big of an issue and isn't worth potentially contracting COVID by having a checked out further. It would be very easy to delay a visit to a doctor. That cough, as we all know, could be an early indication of lung cancer."

Elkins said when she was diagnosed, she didn't have a cough. Her only symptoms were a stiff elbow and neck pain.

"It took me six months constantly pushing for answers to get a completely unexpected lung cancer diagnosis. What if this had been during the pandemic? I'm not sure I would have kept going to the numerous appointments with orthopedists, physical therapists, and rheumatologists that I visited before getting an answer. Instead, I might have believed my primary care physician who told me that I was just getting older at 47 and had an overuse injury from too much electronics," said Elkins.

The study had no commercial funding. Dr. Reyes disclosed relationships with Roche, Bristol Myers Squibb, and Merck.

SOURCE: https://bit.ly/3oEGYOX IASLC World Conference on Lung Cancer, held January 28-31, 2021.

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