Disruptions in Lung Cancer Detection During COVID-19

To quantify the extent of the disruption and recovery of lung cancer detection during the first two years of the pandemic, focusing on disparities across demographic and community factors. This retrospective cohort study used the SEER database to identify lung cancer cases from 2001 to 2021. Expecte...

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Bibliographic Details
Published in:Cancers 2024-12, Vol.16 (23), p.4001
Main Authors: Lal, Trisha, Kim, Uriel, Boutros, Christina S, Chakraborty, Natalie N, Doh, Susan J, Towe, Christopher W, Hoehn, Richard S
Format: Article
Language:English
Subjects:
Age
Black lung
Cancer
COVID-19
Datasets
Diagnosis
Epidemics
Epidemiology
Forecasts and trends
Health aspects
Health care access
Lung cancer
Medical diagnosis
Metastasis
Oncology, Experimental
Pandemics
Patients
Population
Public health
Rural populations
Social aspects
Software
Trends
United States
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Summary:To quantify the extent of the disruption and recovery of lung cancer detection during the first two years of the pandemic, focusing on disparities across demographic and community factors. This retrospective cohort study used the SEER database to identify lung cancer cases from 2001 to 2021. Expected incidence rates for 2020 and 2021 were projected based on pre-pandemic trends (2000-2019) using the NCI's Joinpoint Regression program. Percent differences between expected and observed incidence rates were calculated. Multivariate and propensity score analyses were conducted to quantify changes in the odds of being diagnosed with metastatic disease during the pandemic. Lung cancer incidence fell by 10% in 2020 compared to pre-pandemic projections, with rural populations, non-Hispanic Black and Asian patients, and females disproportionately affected. By 2021, detection rates partially recovered but remained 5% below expected levels. Localized disease detection improved significantly, while rural communities not adjacent to metropolitan areas faced further declines. Adjusted analyses showed that patients with small-cell lung cancer (SCLC) and those of Hispanic, non-Hispanic Black, or Asian/Pacific Islander ethnicity had persistently higher rates of distant disease presentation through 2021. The pandemic significantly reduced lung cancer detection, with only partial recovery by 2021. Persistent gaps, particularly in rural and minoritized populations, highlight the need for targeted interventions to reengage these communities.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers16234001