Abstract
Objectives: The COVID-19 pandemic’s impact on the healthcare system resulted in decreased rates of screening, diagnosis, and treatment of lung malignancies. Long-term longitudinal studies are needed to analyze resultant stage migration.
Materials and Methods: Retrospective cohort study of patients diagnosed with a primary thoracic malignancy (lung, main bronchus, hilum, and carina) who received first-course therapy at a single institution. Clinical and pathological staging values were compared utilizing 12 and 22-month timeframes before (pre-COVID-19) and after (post-COVID-19) the outbreak of the pandemic.
Results: A total of 1,002 patients with clinical stage 0 to IV and 538 patients with pathological stage 0 to IV were analyzed in the pre-COVID-19 and post-COVID-19 populations. Between the 12-month pre- and post-COVID-19 groups, clinical T4 significantly increased (+9.68%). In the 22-month pre- and post-COVID-19 groups, clinical T2 decreased (-7.15%) and T4 increased (+11.53%), pathological T2 decreased (-8.97%) and T4 increased (+8.89%), clinical N2 increased (+6.26%), pathological N0 decreased (-9.22%) and N2 increased (+8.91%), clinical M0 decreased (-8.47%) and M1 increased (+8.47%), pathologic M0 decreased (-11.23%) and M1 increased (+11.23%), clinical stage II decreased (-4.28%) and IV increased (+7.78%), and pathologic stage II decreased (-8.06%) and stage IV increased (+11.08%).
Conclusions: Following the COVID-19 pandemic, significant decreases in the number and availability of lung cancer screenings emerged. This study found statistically significant stage migration at initial diagnosis, particularly when analyzing lengthened time periods of 22 months post-COVID-19 compared to 12 months. Stage migration following the COVID-19 pandemic appears to become more distinguished over time.