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Poster Display session

211P - The impact of the COVID-19 pandemic on lung cancer stage shift and the delivery of surgical lung cancer care in the United States

Date

31 Mar 2023

Session

Poster Display session

Presenters

Alexandra Potter

Citation

Journal of Hepatology (2023) 18 (4S): S154-S159.
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Authors

A. Potter1, S. Papneja2, A. Kumar3, C. Mathey-Andrews4, H.G. Auchincloss4, C.J. Yang4

Author affiliations

  • 1 Massachusetts General Hospital, 02114 - Boston/US
  • 2 MGH - Massachusetts General Hospital, Boston/US
  • 3 New York/US
  • 4 Massachusetts General Hospital, Boston/US

Resources

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Abstract 211P

Background

To investigate whether there was a shift towards later stages of lung cancer diagnosed and worse lung cancer care nationally in the U.S. during the first year of the COVID-19 pandemic.

Methods

Patients diagnosed with stage I-IV non-small cell lung cancer from January 1st, 2015 to December 31st, 2020 in the U.S. National Cancer Database were identified for analysis. Changes in the odds of being diagnosed with one lung cancer stage higher in 2020 vs. 2015–2019 (“pre-pandemic period”) were assessed using multivariable ordinal logistic regression. Of patients diagnosed with stage I NSCLC, changes in the (1) odds of undergoing surgery; (2) odds of receiving delayed surgery (surgery >3 months after diagnosis); and (3) odds of receiving anatomic resection (as opposed to wedge resection) were evaluated using multivariable logistic regression. All multivariable models were adjusted for clinically relevant variables and linear time trends.

Results

A total of 622,983 patients met study inclusion criteria. Compared to the pre-pandemic period, there was a 9% increase in the odds of being diagnosed with one lung cancer stage higher in 2020 (aOR: 1.09, 95% CI: 1.06–1.12, P < 0.001). However, among patients diagnosed with stage I NSCLC, there were no significant changes in the odds of undergoing surgery (aOR: 0.99, 95% CI: 0.94–1.04, P < 0.001) in 2020 compared to the pre-pandemic period. Furthermore, among patients who underwent surgery for stage I NSCLC, there were no significant changes in the odds of receiving delayed surgery (aOR: 1.02, 95% CI: 0.94–1.12, P = 0.62) or odds of receiving an anatomic lung resection (aOR: 0.98, 95% CI: 0.89–1.07, P = 0.61) in 2020 compared to the pre-pandemic period.

Conclusions

In this national analysis, during the first year of the COVID-19 pandemic, surgical lung cancer care delivered by thoracic surgeons was not compromised. However, there was a significant increase in the percentage of patients diagnosed with stage IV NSCLC when compared to the pre-pandemic period. With future COVID-19 surges imminent, the study findings illustrate the urgency of implementing policies that ensure high-risk individuals continue to receive timely lung cancer screening.

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.

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