Increase in lung cancer emergency presentations during the COVID-19 pandemic

Abstract

Emergency presentation (EP) of lung cancer is associated with advanced stage, age and frailty and is a negative predictor of survival and high healthcare costs. There have been significant changes in primary and secondary care services during COVID-19 pandemic and the “stay at home, save lives, protect the NHS” message during the COVID-19 pandemic may have impacted healthcare seeking behaviour. We aim to determine the pandemic's effect on emergency presentations of lung cancer.

Method: Data was retrieved from our trust cancer database for six months before the first COVID-19 lockdown in England (23/09/19–22/03/20) and six months after (23/03/20–22/09/20). EP of lung cancer was defined as new diagnosis of new lung cancer after emergency department or acute medical unit attendance.

Data was analysed for patient characteristics and presentation route. The Chi-square test was used for statistical analysis.

Results: 291 patients were diagnosed with lung cancer in the 6 months prior to COVID-19 lockdown and 271 post-lockdown. Table 1 shows a significantly increased EP from 64 to 86 patients post-lockdown together with a significant increase in hospital versus primary care referrals to the lung cancer service.

Conclusion: We demonstrate increased lung cancer EP after first COVID-19 lockdown. We believe this may be related to altered primary care service, patients not wanting to access healthcare ‘unnecessarily’ and thus not presenting until symptoms trigger emergency admission.