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Multicenter Study
. 2022 Apr;7(2):100406.
doi: 10.1016/j.esmoop.2022.100406. Epub 2022 Feb 3.

Evaluation of COVID-19 impact on DELAYing diagnostic-therapeutic pathways of lung cancer patients in Italy (COVID-DELAY study): fewer cases and higher stages from a real-world scenario

L Cantini  1 , G Mentrasti  2 , G L Russo  3 , D Signorelli  4 , G Pasello  5 , E Rijavec  6 , M Russano  7 , L Antonuzzo  8 , D Rocco  9 , R Giusti  10 , V Adamo  11 , C Genova  12 , A Tuzi  13 , A Morabito  14 , S Gori  15 , N La Verde  16 , R Chiari  17 , A Cortellini  18 , V Cognigni  2 , F Pecci  2 , A Indini  6 , A De Toma  3 , E Zattarin  3 , S Oresti  19 , E G Pizzutilo  19 , S Frega  20 , E Erbetta  20 , A Galletti  7 , F Citarella  7 , S Fancelli  8 , E Caliman  8 , L Della Gravara  21 , U Malapelle  22 , M Filetti  10 , M Piras  10 , G Toscano  23 , L Zullo  24 , M De Tursi  25 , P Di Marino  25 , V D'Emilio  26 , M S Cona  16 , A Guida  27 , A Caglio  28 , F Salerno  28 , G Spinelli  29 , C Bennati  30 , F Morgillo  31 , A Russo  23 , C Dellepiane  24 , I Vallini  13 , V Sforza  14 , A Inno  15 , F Rastelli  32 , V Tassi  33 , L Nicolardi  17 , V Pensieri  18 , R Emili  34 , E Roca  35 , A Migliore  2 , T Galassi  2 , M L Bruno Rocchi  36 , R Berardi  37
Affiliations
Multicenter Study

Evaluation of COVID-19 impact on DELAYing diagnostic-therapeutic pathways of lung cancer patients in Italy (COVID-DELAY study): fewer cases and higher stages from a real-world scenario

L Cantini et al. ESMO Open. 2022 Apr.

Erratum in

Abstract

Introduction: COVID-19 has disrupted the global health care system since March 2020. Lung cancer (LC) patients (pts) represent a vulnerable population highly affected by the pandemic. This multicenter Italian study aimed to evaluate whether the COVID-19 outbreak had an impact on access to cancer diagnosis and treatment of LC pts compared with pre-pandemic time.

Methods: Consecutive newly diagnosed LC pts referred to 25 Italian Oncology Departments between March and December 2020 were included. Access rate and temporal intervals between date of symptoms onset and diagnostic and therapeutic services were compared with the same period in 2019. Differences between the 2 years were analyzed using the chi-square test for categorical variables and the Mann-Whitney U test for continuous variables.

Results: A slight reduction (-6.9%) in newly diagnosed LC cases was observed in 2020 compared with 2019 (1523 versus 1637, P = 0.09). Newly diagnosed LC pts in 2020 were more likely to be diagnosed with stage IV disease (P < 0.01) and to be current smokers (someone who has smoked more than 100 cigarettes, including hand-rolled cigarettes, cigars, cigarillos, in their lifetime and has smoked in the last 28 days) (P < 0.01). The drop in terms of new diagnoses was greater in the lockdown period (percentage drop -12% versus -3.2%) compared with the other months included. More LC pts were referred to a low/medium volume hospital in 2020 compared with 2019 (P = 0.01). No differences emerged in terms of interval between symptoms onset and radiological diagnosis (P = 0.94), symptoms onset and cytohistological diagnosis (P = 0.92), symptoms onset and treatment start (P = 0.40), and treatment start and first radiological revaluation (P = 0.36).

Conclusions: Our study pointed out a reduction of new diagnoses with a shift towards higher stage at diagnosis for LC pts in 2020. Despite this, the measures adopted by Italian Oncology Departments ensured the maintenance of the diagnostic-therapeutic pathways of LC pts.

Keywords: COVID-19; diagnostic delay; lung cancer; staging; therapeutic delay.

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Conflict of interest statement

Disclosure DS received personal fees from AstraZeneca, Merck Sharp & Dohme (MSD), Boehringer Ingelheim and received travel grants from Roche, AstraZeneca, Bristol Myers Squibb (BMS), MSD. AMo received honoraria from Roche, AstraZeneca, Boehringer, Pfizer, MSD, BMS, Novartis, Lilly, Takeda. RC received fees for speaker's bureau and advisory boards participation in BMS, MSD, Roche, Pfizer, AstraZeneca, Takeda, Amgen, Boehringer, Novartis. FM received founding from AstraZeneca, Incyte and served as consultant for MSD. RB is a consultant/advisory board member for AstraZeneca, Boehringer Ingelheim, Novartis, MSD, Otsuka, Eli Lilly, Roche. All other authors have declared no conflicts of interest.

Figures

Figure 1
Figure 1
STROBE diagram. Identification and selection of study population according to inclusion and exclusion criteria.
Figure 2
Figure 2
Monthly differences of new lung cancer diagnoses between 2019 and 2020. April, May, and June 2020 (in bold type) were considered as the lockdown timeframe.
Figure 3
Figure 3
Differences of new lung cancer diagnoses between 2019 and 2020 by provinces included in our Italian multicentric study.
See this image and copyright information in PMC

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