The Impact of the COVID-19 Pandemic on Lung Cancer Diagnosis

INTRODUCTION: During the COVID-19 pandemic, a decrease in hospital admissions has been observed due to fear of exposure to the infectious agent. This situation has raised concerns about a decrease in presentations and delays in diagnosis among patients with symptoms and suspicion of lung cancer. Additionally, it is argued that the increase in the number of thoracic computed tomography scans due to COVID-19 infection supports the view that lung cancer is being detected in early stages. In this study, we aimed to investigate the impact of the
pandemic on the diagnosis of lung cancer.
METHODS: Patients diagnosed with lung cancer in our hospital between 2019-2021 were evaluated retrospectively. The sex, age, TNM classifications, stages, pathological diagnoses and treatments of the patients were recorded and the one-year periods before and after the start of pandemic were compared.
RESULTS: 348 patients with lung cancers were included in the study. It was observed that 292 of these patients were diagnosed with non-small cell lung cancer, and 56 patients were diagnosed with small cell lung cancer. 182 patients were detected at the 1A-3A stages of non-small cel lung cancer, relatively early stages, while 110 were detected at the 3B-4B stages at diagnosis. The rate of early-stage non-small cell lung cancer diagnosis was 70.3% before the pandemic and 56.1% after the start of pandemic, with a statistically significant difference (p=0.013). It was found that the rate of those who underwent curative surgery in the nonsmall cell lung cancer group after the start of pandemic decreased (83/164, 50.6%) when the patient groups were compared in terms of treatment before the pandemic (80/128, %62.5) (p=0.034).
DISCUSSION AND CONCLUSION: Our findings indicate that lung cancer diagnoses may have been delayed due to the restrictions during the pandemic and the anxiety of contracting the disease, or due to the increased burden on health care system.

COVID-19 Pandemisinin Akciðer Kanseri Tanýsý Üzerindeki Etkisi

GÝRÝÞ ve AMAÇ: COVID-19 pandemisinde bulaþýcý ajana maruz kalma korkusu ile hastane baþvurularýnda azalma görülmüþtür. Bu durumun, akciðer kanseri semptomlarý ve þüphesi olan hastalarýn baþvurularýnda azalma ve tanýda gecikmeler olabileceðini düþündürmüþtür. Bunun yaný sýra COVID-19 enfeksiyonu sebebiyle çekilen toraks bilgisayarlý tomografi sayýsý arttýðýndan akciðer kanserinin erken evrelerde yakalandýðý görüþü de savunulmaktadýr. Biz bu çalýþmada pandeminin akciðer kanseri tanýsý üzerine etkisini araþtýrmayý amaçladýk.
YÖNTEM ve GEREÇLER: Hastanemizde 2019-2021 yýllarý arasýnda akciðer kanseri teþhisi konmuþ hastalar retrospektif olarak deðerlendirildi. Hastalarýn cinsiyeti, yaþý, TNM sýnýflandýrmalarý, evreleri, patolojik teþhisleri ve tedavileri kaydedildi ve pandemi öncesi ve sonrasý bir yýllýk dönemler karþýlaþtýrýldý.
BULGULAR: Çalýþmaya 348 akciðer kanseri tanýsý konulan hasta dahil edildi. Bu hastalarýn 292’sine küçük hücreli dýþý akciðer kanseri tanýsý, 56 hastaya ise küçük hücreli akciðer kanseri tanýsý konulduðu görüldü. Küçük hücreli dýþý akciðer kanserlerinin nispeten erken evre olan Evre 1A-3A evresinde 182 hasta tespit edilirken, 110 hasta ise 3B-4B evresinde tespit edildi. Pandemi öncesi dönemde erken evre küçük hücre dýþý akciðer kanseri teþhisi oraný %70.3 iken, pandemi baþlangýcýndan sonraki dönemde %56.1 olarak bulundu ve bu iki grup arasýnda istatistiksel olarak anlamlý bir fark tespit edildi (p=0.013). Küçük hücreli dýþý akciðer kanseri grubunda pandemi baþlangýcýndan sonraki dönemde küratif cerrahi geçirenlerin oraný (83/164, %50.6), pandemi öncesi döneme (80/128, %62.5) göre karþýlaþtýrýldýðýnda istatistiksel olarak anlamlý olarak azalmýþ olduðu görüldü (p=0.034).
TARTIÞMA ve SONUÇ: Bulgularýmýz, pandemi sýrasýndaki kýsýtlamalar, hastalýða yakalanma kaygýsý ve saðlýk sistemindeki artan yük nedeniyle akciðer kanseri teþhisinin gecikmiþ olabileceðini göstermektedir.