Impact of the COVID-19 pandemic on the diagnosis of lung cancer in northeastern Brazil

Caminha, Iusta; Távora, Fábio; Sousa, Juliana Barbosa de; Neto, Francisco Martins; Cavalcanti, Luciano Pamplona de Góes

doi:10.36416/1806-3756/e20220248

Cited by 4 publications

(5 citation statements)

References 11 publications

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“…In our previous research publications [ 12 , 13 ], we highlighted a significant decline in the incidence of new lung cancer cases during the initial phase. This observation is consistent with widespread global reports documenting similar trends [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. Following the decline witnessed initially, we observed a significant resurgence in the incidence of new cases, with an escalation of 79% during the second year of the pandemic.…”

Section: Discussionsupporting

confidence: 92%

“…Numerous studies have shed light on a concerning phenomenon within the realm of oncology: a marked decline in the detection of new lung cancer cases coupled with a concerning shift in the stage at which these malignancies are being diagnosed. These studies collectively underscore the profound impact that the pandemic, particularly its initial lockdown measures, has had on lung cancer diagnosis and presentation [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

“…1 Pericardial/pleural effusion or contralateral lung; 2 Single extrathoracic site; 3 Multiple extrathoracic sites.…”

mentioning

confidence: 99%

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Real-World Evidence of the Impact of the COVID-19 Pandemic on Lung Cancer Survival: Canadian Perspective

Agulnik,

Kasymjanova,

Pepe

et al. 2024

Current Oncology

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Background: The effect of COVID-19 on treatment outcomes in the literature remains limited and is mostly reported either as predictive survival using prioritization and modeling techniques. We aimed to quantify the effect of COVID-19 on lung cancer survival using real-world data collected at the Jewish General Hospital, Montreal. Methods: This is a retrospective chart review study of patients diagnosed between March 2019 and March 2022. We compared three cohorts: pre-COVID-19, and 1st and 2nd year of the pandemic. Results: 417 patients were diagnosed and treated with lung cancer at our centre: 130 in 2019, 103 in 2020 and 184 in 2021. Although the proportion of advanced/metastatic-stage lung cancer remained the same, there was a significant increase in the late-stage presentation during the pandemic. The proportion of M1c (multiple extrathoracic sites) cases in 2020 and 2021 was 57% and 51%, respectively, compared to 31% in 2019 (p < 0.05). Median survival for early stages of lung cancer was similar in the three cohorts. However, patients diagnosed in the M1c stage had a significantly increased risk of death. The 6-month mortality rate was 53% in 2021 compared to 47% in 2020 and 29% in 2019 (p = 0.004). The median survival in this subgroup of patients decreased significantly from 13 months in 2019 to 6 months in 2020 and 5 months in 2021 (p < 0.001). Conclusions: This study is, to our knowledge, the largest single-institution study in Canada looking at lung cancer survival during the COVID-19 pandemic. Our study looks at overall survival in the advanced/metastatic setting of NSCLC during the COVID-19 pandemic. We have previously reported on treatment pattern changes and increased wait times for NSCLC patients during the pandemic. In this study, we report that the advanced/metastatic subgroup had both an increase in the 6-month mortality rate and worsening overall survival during this same time period. Although there was no statistical difference in the proportion of patients with advanced disease, there was a concerning trend of increased M1c disease in cohorts 2 and 3. The higher M1c disease during the COVID-19 pandemic (cohorts 2 and 3) likely played a crucial role in increasing the 6-month mortality rate and leading to a reduced overall survival of lung cancer patients during the pandemic. These findings are more likely to be better identified with longer follow-up.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Real-World Evidence of the Impact of the COVID-19 Pandemic on Lung Cancer Survival: Canadian Perspective

Agulnik,

Kasymjanova,

Pepe

et al. 2024

Current Oncology

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“…However, many surgeries were canceled due lack of beds in intensive care units (ICU) for postoperation observance since the ICU beds were relocated to patients with con rmed COVID-19 or acute respiratory distress. Also, during the COVID-19 pandemic, over 70% of these 1000 beds were turned into respiratory wings; such approach was also observed in other cancer centers in the country (14).…”

Section: Discussionmentioning

confidence: 61%

Impact of COVID-19 pandemic among patients with lung and head and neck cancer assisted in a public cancer center in Brazil

Veloso

Amaral

Nogueira-Rodrigues

2023

Preprint

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Background There is no updated national data regarding the real impact of the COVID-19 pandemic on delaying diagnosis and treatment among patients with lung, and head, and neck cancers in Brazil. This study aimed to analyze the COVID-19 pandemic impact on cancer diagnosis and clinical outcomes among lung, head, and neck cancer patients assisted in a tertiary cancer center in Southeastern Brazil, as well as to analyze these patients’ pretreatment clinical features.Methods Retrospective cohort of patients with lung or head and neck cancer assisted in a tertiary cancer center in southeastern Brazil between January/2019 and December/2021. To assess statistical differences among groups [i.e., cohort 2019 versus (vs.) 2020 and 2019 vs. 2021] chi-square test was used with a 5% significance level and 90% power for sample size calculation. Differences among baseline clinical features and sociodemographic characteristics were evaluated either by T-test for two samples or Fisher’s or Pearson’s chi-square test (for quantitative or qualitative variables). All utilized tests had a 5% significance level.Results 652 patients were included, 332 with lung and 320 with head and neck cancer; it was observed a significant decrease in oncologic treatment recommendations and increase in palliative care recommendation for patients with lung cancer, despite similar stages at diagnosis. During the COVID-19 pandemic, more pain symptoms were reported at the first Oncology assessment (p < 0.05 in all of them). Compared to 2019, head and neck cancer patients diagnosed in 2021 presented a worse initial performance status (p = 0.017). There was a statistically significant reduction in mortality for patients diagnosed with head and neck cancer in 2021 when compared to 2019 (p = 0.003).Conclusions This research highlights high mortality rates for patients with lung and head and neck cancer in Brazil, even before the pandemic started, as consequence of advanced diseases at diagnosis and limited access to best treatment options at the publica health system. This is a reflection of how fragile the public healthcare system even before facing an acute public health crisis such as the COVID-19 pandemic. Yet, the total impact on public health may follow for many years.

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“…However, many surgeries were canceled due lack of beds in intensive care units (ICU) for post-operation observance since the ICU beds were relocated to patients with confirmed COVID-19 or acute respiratory distress. Also, during the COVID-19 pandemic, over 70% of these 1000 beds were turned into respiratory wings; such approach was also observed in other cancer centers in the country [ 13 ]. Worldwide the COVID-19 pandemic impacted cancer care; a global collaborative study across 54 countries [ 14 ] reported that in over 88% of the participating cancer centers there was challenges in providing adequate cancer care during the pandemic, including number of medical appointments, restricted access to medications, and missing on chemotherapy cycles.…”

Section: Discussionmentioning

confidence: 85%

Impact of COVID-19 pandemic among patients with lung and head and neck cancer assisted in a public cancer center in Brazil

Viana Veloso,

Amaral,

Nogueira-Rodrigues

2024

BMC Cancer

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Background There is no updated national data regarding the real impact of the COVID-19 pandemic on delaying diagnosis and treatment among patients with lung, and head, and neck cancers in Brazil. This study aimed to analyze the COVID-19 pandemic impact on cancer diagnosis and clinical outcomes among lung, head, and neck cancer patients assisted in a tertiary cancer center in Southeastern Brazil, as well as to analyze these patients’ pretreatment clinical features. Methods Retrospective cohort of patients with lung or head and neck cancer assisted in a tertiary cancer center in southeastern Brazil between January/2019 and December/2021. To assess statistical differences among groups [i.e., cohort 2019 versus (vs.) 2020 and 2019 vs. 2021] chi-square test was used with a 5% significance level and 90% power for sample size calculation. Differences among baseline clinical features and sociodemographic characteristics were evaluated either by T-test for two samples or Fisher’s or Pearson’s chi-square test (for quantitative or qualitative variables). All utilized tests had a 5% significance level. Results Six hundred fifty-two patients were included, 332 with lung and 320 with head and neck cancer; it was observed a significant decrease in oncologic treatment recommendations and increase in palliative care recommendation for patients with lung cancer, despite similar stages at diagnosis. During the COVID-19 pandemic, more pain symptoms were reported at the first Oncology assessment for patients with head and neck cancer (p < 0.05). Compared to 2019, head and neck cancer patients diagnosed in 2021 presented a worse initial performance status (p = 0.008). There was a statistically significant increase in survival for patients diagnosed with head and neck cancer in 2021 when compared to 2019 (p = 0.003). Conclusions This research highlights low survival rates for patients with lung and head and neck cancer in Brazil, even before the pandemic started, as consequence of advanced diseases at diagnosis at the public health system and clinical degrading features. Additionally, there was an increase incidence in both lung cancer and head and neck cancer despite no differences in clinical stage. This reflects how fragile is the public healthcare system even before facing an acute public health crisis such as the COVID-19 pandemic. Yet, the total impact on public health may follow for many years.

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Impact of the COVID-19 pandemic on the diagnosis of lung cancer in northeastern Brazil

Cited by 4 publications

References 11 publications

Real-World Evidence of the Impact of the COVID-19 Pandemic on Lung Cancer Survival: Canadian Perspective

Real-World Evidence of the Impact of the COVID-19 Pandemic on Lung Cancer Survival: Canadian Perspective

Impact of COVID-19 pandemic among patients with lung and head and neck cancer assisted in a public cancer center in Brazil

Impact of COVID-19 pandemic among patients with lung and head and neck cancer assisted in a public cancer center in Brazil

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