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Lung Cancer Stage Shift as a Result of COVID-19 Lockdowns in New York City, a Brief Report

. 2022 May;23(3):e238-e242. doi: 10.1016/j.cllc.2021.08.010. Epub 2021 Aug 29. Lung Cancer Stage Shift as a Result of COVID-19 Lockdowns in New York City, a Brief Report

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Lung Cancer Stage Shift as a Result of COVID-19 Lockdowns in New York City, a Brief Report

Nathan Mynard et al. Clin Lung Cancer. 2022 May.

. 2022 May;23(3):e238-e242. doi: 10.1016/j.cllc.2021.08.010. Epub 2021 Aug 29. Authors Nathan Mynard  1 Ashish Saxena  2 Alexandra Mavracick  2 Jeffrey Port  1 Benjamin Lee  1 Sebron Harrison  1 Oliver Chow  1 Jonathan Villena-Vargas  1 Ronald Scheff  2 Giuseppe Giaccone  2 Nasser Altorki  3 Affiliations

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Abstract

Introduction: The COVID-19 pandemic reached New York City in early March 2020 resulting in an 11-week lockdown period to mitigate further spread. It has been well documented that cancer care was drastically affected as a result. Given New York City's early involvement, we attempted to identify any stage shift that may have occurred in the diagnoses of non-small cell lung cancer (NSCLC) at our institution as a result of these lockdowns.

Patients and methods: We conducted a retrospective review of a prospective database of lung cancer patients at our institution from July 1, 2019 until March 31, 2021. Patients were grouped by calendar year quarter in which they received care. Basic demographics and clinical staging were compared across quarters.

Results: Five hundred and fifty four patients were identified that underwent treatment during the time period of interest. During the lockdown period, there was a 50% reduction in the mean number of patients seen (15 ± 3 vs. 28 ± 7, P = .004). In the quarter following easing of restrictions, there was a significant trend towards earlier stage (cStage I/II) disease. In comparison to quarters preceding the pandemic lockdown, there was a significant increase in the proportion of patients with Stage IV disease in the quarters following phased reopening (P = .026).

Conclusion: After a transient but significant increase in Stage I/II disease with easing of restrictions there was a significant increase in patients with Stage IV disease. Extended longitudinal studies must be conducted to determine whether COVID-19 lockdowns will lead to further increases in the proportion of patients with advanced NSCLC.

Keywords: Cancer care delays; NSCLC; Pandemic; SARS-CoV-2; Thoracic oncology.

Copyright © 2021 Elsevier Inc. All rights reserved.

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Figures

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Graphical representation of the monthly…

Figure 1

Graphical representation of the monthly and quarterly sum of patient encounters during the…

Figure 1

Graphical representation of the monthly and quarterly sum of patient encounters during the study time-period. The blue line represents monthly sums, and the orange boxes represent quarterly sums. The asterisk highlights the yearly quarter most affected by the New York State lockdown.

Figure 2

Quarterly clinical stage distribution as…

Figure 2

Quarterly clinical stage distribution as a percentage of the total diagnoses across the…

Figure 2

Quarterly clinical stage distribution as a percentage of the total diagnoses across the study time-period. The asterisk highlights the yearly quarter with patient volume most affected by the New York State lockdown.

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