Introduction

We explored the impact of the COVID-19 pandemic on patients presenting with lung cancer to our hospital, comparing pre-pandemic (Apr 2019 to Apr 2020), pandemic (Apr 2020 to Apr 2021) and post pandemic data (Apr 2021 to Apr 2022).

Method

All patients presenting with lung cancer were identified. Electronic notes were used to assess demographics, staging and treatment received. Data was analysed using STATA version 17.

Results

556 patients (male 47.3%) were diagnosed with lung cancer between Apr 2019 ? Apr 2022. The number of patients diagnosed fell by 30% in the pandemic year (n=154) compared to pre-pandemic (n=222) and recovered partially post-pandemic (n=180). A reduced proportion presented with stage 1 lung cancer during the pandemic (27.5%) compared to pre-pandemic (36.5%), which has returned to baseline 35.5% post-pandemic. However, the proportion of patients with lung cancer having surgical resection has fallen from 26.1% pre-pandemic to 21.2% post pandemic whilst the numbers having stereotactic radiotherapy has been stable at 13%. In stage 1 and 2 patients, there has been a 21% fall in those who are performance status (PS) 0-1 post- compared with pre-pandemic and a 9% rise in those with PS 3-4.

Conclusion

The drop in lung cancer diagnosis during the pandemic was due to reduced cardiovascular CT imaging in our tertiary centre with less incidental cancer pick up and hospital avoidance due to shielding. Patients post-pandemic presented with worse PS, possibly as a result of deconditioning or deteriorating co-morbidities during the pandemic, which led to a reduction in those fit enough to have surgery. The ?lost? patients in the pandemic year have not yet surfaced.