Impact of COVID-19 on Timeliness of Receiving Systemic Therapy for Patients Diagnosed with Lung Cancer

During the COVID-19 pandemic, patients newly diagnosed with lung cancer faced potential delays in accessing timely cancer treatment. Little information exists on how COVID-19 impacted the timeliness of receiving a first course of systemic therapy after a lung cancer diagnosis.

Data from the Population-based Research to Optimize the Screening Process-Lung Consortium were used to identify patients diagnosed with Stage I to IV lung cancer between January 1, 2018 and September 30, 2021, for this retrospective cohort study. The patients were categorized into three groups based on the date of diagnosis: pre-COVID-19 (January 1, 2018-March 14, 2020), early COVID-19 (March 15, 2020-June 30, 2020), and late COVID-19 (July 1, 2020-September 30, 2021). We explored changes in the time from cancer diagnosis to initiation of the first course of systemic therapy using interrupted time series (ITS) analysis across the pre-, early, and late COVID-19 time periods.

We identified 810 patients with lung cancer who received a first course of systemic therapy during the study period. The average number of patients diagnosed with lung cancer per month decreased from 17.0 in the pre-COVID-19 period to 15.3 in the early COVID-19 period and then increased to 19.3 in the late COVID-19 period. ITS models estimated a 9.6-day increase (95% confidence interval: 4.8, 14.5; P < 0.01) from lung cancer diagnosis to treatment initiation at the start of the early COVID-19 period. The time from lung cancer diagnosis to treatment initiation returned to pre-COVID-19 levels by the start of the late COVID-19 period.

Our findings indicate a delay in initiating systemic therapy among patients with lung cancer during the early COVID-19 period compared to the pre- and late COVID-19 periods; however, the time to initiating treatment recovered quickly.