1432P - Tumor stage shift in lung cancer during the COVID-19 pandemic: A real-world data study of the Network Oncology Registry

Background

Lung cancer patients are vulnerable towards severe COVID-19 outcomes due to multiple risk factors such as smoking, older age or certain cancer treatments. During the COVID-19 pandemic the lung cancer care was significantly altered. As increasing data point towards a shift towards the diagnosis of more advanced tumors during the pandemic in lung cancer patients we evaluated cancer stages I-IV in lung cancer, especially NSCLC patients, newly diagnosed between 2018 and 2022 in a certified German lung cancer center.

Methods

Demographic data as well as tumor-related data were retrieved from the network oncology registry and evaluated retrospectively at the time of diagnosis. The study has been approved by the ethics committee of the Medical Association Berlin (Eth-27/10).

Results

In total 1118 lung cancer patients were included in the registry study. Comparing lung cancer patients from single pandemic years to the pre-pandemic year 2018, a significant 6.9% (p=0.02) drop of stage II lung cancer diagnoses was seen in 2022. Furthermore, when looking at NSCLC patients, significant tumor stage shifts were observed during 2021 and 2022: while the proportion of stage IV diagnosed NSCLC patients increased by 10.7% (p=0.03) during 2021, the proportion of stage II NSCLC decreased by 8.2% (p=0.01) in the following year compared to the pre-pandemic year 2018. No significant shifts were observed for SCLC patients. Finally yet importantly, a 12% decline of lung cancer diagnoses in 2021 and a 17.2% decline in 2022 was documented when comparing with diagnoses in 2018.

Conclusions

COVID-19-related delays and patient’s reluctance have led to clinically meaningful decreases of lung cancer diagnoses in a certified German lung cancer center. Additionally, a significant increase of stage IV NSCLC diagnosis (2021) and a significantly decreased diagnosis of stage II lung cancer, particularly NSCLC tumors (2022), during the COVID-19 pandemic were observed. The implication of these results on the cancer care, patient’s health-related quality of life and the lung cancer mortality will need to be urgently evaluated in the near future.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

Research Institute Havelhöhe at the hospital Gemeinschaftskrankenhaus Havelhöhe.

Funding

AstraZeneca GmbH.

Disclosure

B.S. Matthes: Financial Interests, Institutional, Other, Travel cost: AstraZeneca GmbH, Boehringer Ingelheim AG & Co.; Financial Interests, Institutional, Other, Travel costs: Lilly Deutschland; Financial Interests, Institutional, Advisory Board: Janssen-Cilag GmbH, Novartis Pharma GmbH, MSD Sharp & Dohme GmbH, Gilead Sciences GmbH. C. Grah: Financial Interests, Institutional, Invited Speaker: AstraZeneca GmbH, Wala Heilmittel GmbH; Financial Interests, Institutional, Research Grant: Iscador AG. P. Grabowski: Financial Interests, Institutional, Invited Speaker: Ipsen Pharma, Helixor Heilmittel GmbH. F. Schad: Financial Interests, Institutional, Invited Speaker: AstraZeneca GmbH, Helixor Heilmittel GmbH; Financial Interests, Institutional, Funding: Abnoba GmbH, Iscador AG, Helixor Heilmittel GmbH. All other authors have declared no conflicts of interest.