Collateral impact of COVID19 pandemic on lung cancer services in a tertiary referral centre

Abstract

Introduction: The COVID-19 pandemic has been predicted to significantly affect overall patients with lung cancer and healthcare systems.

Aim: To investigate the impact of COVID-19 pandemic on lung cancer diagnostic and treatment services in a tertiary referral centre.

Materials and Methods: Targeted retrospective review of all hospital records and electronic databases for diagnostic/therapeutic procedures for lung cancer&systemic treatments/ immunotherapies during the pandemic (03/2020-12/2020) and comparison with previous year (03/2019-12/2020).

Results: Our Trust is a tertiary referral centre for Respiratory Medicine. During the pandemic, 257 active lung cancer outpatient cases were recorded versus 784 (03.2019-12.2019) resulting in a 68% decrease. Diagnostic/therapeutic bronchoscopies sustained a 39% decrease, thoracic surgery cases decreased by 42% and chemotherapies/immunotherapies were reduced by 12%. Compellingly, the graphical monthly breakdown of outpatients/procedures/treatments is inversely proportional to the pandemic curve and state lockdowns. Despite the significant decrease in outpatient cases (including new referrals) the decrease is systemic treatments was significantly less accounting for the extent of disease recurrences requiring second line treatment. Interestingly, systemic treatments’ costs have increased by 24% despite the 12% decrease in their numbers which is attributed to the increased use of immunotherapy as 2nd line treatment in disease recurrences.

Conclusions: The COVID19 pandemic poses implications in our Trust’s lung cancer services including costs and follows a pattern that is inversely proportional to the pandemic curve.