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. 2023 Aug 17;4(10):100560.
doi: 10.1016/j.jtocrr.2023.100560. eCollection 2023 Oct.

Lung Cancer Treatment Trends During the Coronavirus Disease 2019 (COVID-19) Pandemic: A Claims and Order Data Analysis (2019-2021)

Adam C Powell  1   2 , Logan M Horrall  1 , James W Long  3 , Bryan A Loy  3 , Amin J Mirhadi  1
Affiliations

Lung Cancer Treatment Trends During the Coronavirus Disease 2019 (COVID-19) Pandemic: A Claims and Order Data Analysis (2019-2021)

Adam C Powell et al. JTO Clin Res Rep. .

Abstract

Introduction: Lung cancer is treated using systemic therapy, radiation therapy (RT), and surgery. This study evaluates how utilization of these modalities and cancer stage at initial treatment shifted from 2019 to 2021.

Methods: Claims for lung cancer treatment were extracted from the database of a national health care organization offering Medicare Advantage health plans and paired with enrollment data to determine utilization rates. Seasonally adjusted rates were trended, with monotonicity evaluated using Mann-Kendall tests. Using contemporaneous prior authorization order data, the association between year and the patient's cancer stage at the time of the initial RT or surgery order was evaluated through univariable and multivariable analyses.

Results: The study considered 140.9 million beneficiary-months of data. There were negative and significantly monotonic trends in utilization of RT (p = 0.033) and systematic therapy (p = 0.003) for initial treatment between January 2020 and December 2021. Analysis of RT and surgery order data revealed that the patients were significantly (p < 0.001) more likely to have advanced (stage III or IV) cancer at the time of their surgery order in 2020 and 2021 than in 2019. After adjusting for urbanicity, age, and local income, a significant relationship between year of the initial order and presence of advanced cancer at the time of ordering was found for surgery orders placed in 2020 (p < 0.001) and 2021 (p < 0.01), but not for RT orders.

Conclusions: There was a per-capita reduction in lung cancer treatment in 2020 and 2021, and patients receiving initial orders for surgery after the onset of the pandemic had more advanced cancer.

Keywords: COVID-19; Radiation therapy; Surgery; Systemic therapy; Wedge resection.

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Figures

Figure 1
Figure 1
Month-by-month initial treatment utilization in 2020 and 2021, relative to the same month in 2019. Apr, April; Aug, August; Dec, December; Feb, February; Jan, January; Jul, July; Jun, June; Mar, March; Nov, November; Oct, October; RT, radiation therapy; Sep, September.
Figure 2
Figure 2
Month-by-month total treatment utilization in 2020 and 2021, relative to the same month in 2019. Apr, April; Aug, August; Dec, December; Feb, February; Jan, January; Jul, July; Jun, June; Mar, March; Nov, November; Oct, October; RT, radiation therapy; Sep, September.
Figure 3
Figure 3
Participant selection diagram. RT, radiation therapy.
Figure 4
Figure 4
Distribution of patient stage at time of treatment by year and treatment type. RT, radiation therapy.
See this image and copyright information in PMC

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References

    1. Centers for Medicare & Medicaid Services CMS releases recommendations on adult elective surgeries, non-essential medical, surgical, and dental procedures during COVID-19 response. https://www.cms.gov/newsroom/press-releases/cms-releases-recommendations...
    1. Dingemans A.M., Soo R.A., Jazieh A.R., et al. Treatment guidance for patients with lung cancer during the coronavirus 2019 pandemic. J Thorac Oncol. 2020;15:1119–1136. - PMC - PubMed
    1. Bakhribah H., Zeitouni M., Daghistani R.A., et al. Implications of COVID-19 pandemic on lung cancer management: a multidisciplinary perspective. Crit Rev Oncol Hematol. 2020;156 - PMC - PubMed
    1. Banna G., Curioni-Fontecedro A., Friedlaender A., Addeo A. How we treat patients with lung cancer during the SARS-CoV-2 pandemic: primum non nocere. ESMO Open. 2020;5 - PMC - PubMed
    1. Calabrò L., Peters S., Soria J.C., et al. Challenges in lung cancer therapy during the COVID-19 pandemic. Lancet Respir Med. 2020;8:542–544. - PMC - PubMed

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