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The impact of COVID-19 on thoracic surgical procedures in Japan: Analysis of data from the National Clinical Database
Yukio Sato1, Hiroyuki Yamamoto1, Norihiko Ikeda1
1Department of Thoracic Surgery, University of Tsukuba, Ibaraki, Japan; Department of Healthcare Quality Assessment, The University of Tokyo, Tokyo, Japan; Department of Surgery, Tokyo Medical University, Tokyo, Japan; Japan Cancer Society, Tokyo, Japan; Department of Thoracic Surgery, Jichi Medical University, Tochigi, Japan; Department of Thoracic Surgery, Tohoku University, Miyagi, Japan; Department of General Thoracic Surgery, Kyorin University, Tokyo, Japan; Department of Thoracic Surgery, Osaka University, Osaka, Japan; Department of Thoracic Surgery, Okayama University, Okayama, Japan; Department of Thoracic Surgery, Tottori University, Tottori, Japan; Department of Thoracic Surgery, Fujita Health University, Aichi, Japan; Department of Thoracic Surgery, Nagoya University, Aichi, Japan; Department of Thoracic Surgery, Chiba University, Chiba, Japan; Japan Cancer Society, Tokyo, Japan; Department of Thoracic Surgery, Dokkyo Medical University, Tochigi, Japan.
Objective:
The COVID-19 pandemic has far-reaching collateral health impacts on the ongoing delivery of surgical care worldwide. The current study was designed to analyze the impact of the COVID-19 pandemic on the number of surgeries of general thoracic surgery in Japan.
Methods:
Changes in the number of surgeries for total and three representative tumors were analyzed using the National Clinical Database data with reference to the pandemic infection rate and lung cancer screening.
Results:
In 2020, the number of surgeries in total and for primary lung cancer and mediastinal lung tumor decreased by 4.9, 5.1, and 5.0 %, respectively. Considering the five-year trend towards a 5 % annual increase, there was a potential 10 % decrease in the number of primary lung cancer surgeries. The number of primary lung cancer surgeries bottomed in July 2020 but recovered towards the end of the year. In contrast, the number of metastatic lung tumor surgeries in 2020 increased by 3.2 %, following a similar trend observed over the previous five years. The number of lung cancer screening examinees decreased markedly with the lowest number in May. Our findings indicate that surgical triage had a limited impact on the decrease in primary lung cancer surgeries during the pandemic; rather, the decrease in lung cancer screening, which was a few months preceding, is most likely responsible.
Conclusions:
The decrease in primary lung cancer was mainly caused by the decrease in lung cancer screening, indicating that continuing screening is vital even during a pandemic.
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