Lung cancer diagnoses during the SARS-CoV-2 pandemic

Title: Lung cancer diagnoses during the SARS-CoV-2 pandemic
Author(s): D. Parfrey, G. O’Dea, G. Cogan, J. McDonnell, T. Hassan, I. Counihan
Institution: OLOL Hospital, Drogheda
Poster: Click to view poster
Category: Lung Cancer/CF/ILD/Surgery
Abstract: Introduction
Lung cancer is the leading cause of cancer-related deaths in the Republic of Ireland (ROI), despite being the fifth most common form of cancer in the country.
Common presenting symptoms of cough and dyspnoea are non-specific and widespread screening is not in place in ROI at the time of writing. For these reasons most lung cancer cases are diagnosed at an advanced stage, where treatment options are limited and prognosis is poorer.

The OLOL Hospital Drogheda Rapid Access Lung Cancer Service continues to operate and accept referrals during the the SARS-CoV-2 pandemic, and has done so for the duration of the pandemic thus far.

We observed incidence of new diagnoses of lung cancer in OLOL in the ‘first wave’ of the SARS-CoV-2 pandemic between 1 March and 30 June 2020, compared to a reference period of the same dates in 2019.

We performed a retrospective review using a collaborative database of lung cancer diagnoses kept in OLOL Hospital to identify new diagnosis during the period in question compared to the reference period in 2019.

We aimed to test the hypothesis that during the covid-19 pandemic, avoidance of health services and hospitals by patients would lead to decreased incidence of lung cancer diagnoses within the service, and that reduced scheduled care and closure of services increased delays in treatment for those for whom radical treatment was planned.

During the study period, 38 cases of lung cancer were diagnosed in OLOL. This compares to 26 cases in the same time period in the year before, representing an increase of 46.2% (RR = 1.46).

There has been concern that reduced scheduled care could lead to delayed cancer diagnosis during the SARS-CoV-2 pandemic. Indeed, overseas health services have reported decreased cancer diagnosis during this time4.
Contrary to this concern, we observed an increased incidence of lung cancer diagnosis during the ‘first wave’ of the pandemic.

We hypothesise that the increased incidence of lung cancer noticed by our service may be related to patients seeking medical attention for symptoms suspicious for SARS-CoV-2, which overlap with those of lung cancer, and undergoing thoracic imaging, which often involves CT-Thorax for radiological diagnosis of SARS-CoV-25.