Abstract

Introduction/Aims

This study investigated whether the Covid-19 pandemic affected lung cancer presentation, in particular whether patients presented with later stage disease at diagnosis.

Methods

This retrospective cohort study analysed new primary lung cancers staged at Lung Cancer multi-disciplinary meeting in a tertiary referral centre. We compared cancer stage in a 6-month period before the Covid-19 pandemic (Apr‘19-Sept‘19, Group 1) to a similar period following the start of the pandemic (Sept’20-Feb’21, Group 2). Comparison of patient demographics, tumour staging and treatment referrals were made.

Results

In Group 1, 91 new lung cancers were staged at the Lung Cancer MDT, with a median age of 68. 58% of patients were male. In Group 2, fewer patients (41) were staged, with a median age of 70, with the majority being female (56%). 39% of those in Group 2 were current smokers versus 29.6% in Group 1. Median tumour size at time of diagnosis was larger in Group 2 (5.6cm vs 4.1cm), reflecting overall upgrading from T3 to T4. Group 2 presented with higher stage nodal disease, where 36.5% of patients presented with N3 disease, versus 20.9% in Group 1. Both groups saw approximately 30% of patients with metastatic disease (M-stage) at time of presentation.

Conclusion

This study suggests patients are presenting with more advanced disease following the pandemic, with larger tumours, and higher burden of nodal disease. The cause for this is likely multifactorial, and may include patient reluctance to present to doctors for review. Further study is required to explore factors such as patient education and lung cancer screening that may prevent this trend towards later presenting disease.