Abstract

Background: UK restrictions during covid-19 impacted lung cancer care including referrals into secondary care.

Aims: (1) document pattern of referrals to this semi-rural Trust, (2) evidence any later presentation of disease, and (3) report impact on treatment.

Method: Data was collected retrospectively and analysed for pre-covid, lockdown/restriction period, and post-relaxation of rules. Non-parametric data were analysed by chi square (X2) analysis for trend.  

Results: Fall in referrals pivoted on the initial UK peak in 2020 with a slow recovery in two week wait referrals post-lockdown (43%, previously 60%). Table 1 shows distribution in disease stage negatively skewed (all >2.46) with the majority at stage 4. Trend showed no statistical difference in stage with X2 (df 6, n=792, = 3.831, p=.6995) and similarly when re-analysing earlier stages. Treatment outcome shows non-significant trends to increased palliative care (28 to 35%) and radiotherapy (10 to 18%), with less chemotherapy (25 to 21%) or surgery (26 to 15%).

Conclusions: Locally, lung cancer diagnosis numbers have been maintained, with a similar stage at presentation but a change in referral pattern favouring emergency/upgraded presentation may signal reduced access to primary care.