Impact of the coronavirus pandemic and national lockdown on a lung cancer service – opportunities for innovation

Published Date: 16th June 2021

Publication Authors: Malhotra P, McIntosh A, Peers V

Background
Timely diagnosis and access to treatment are key factors in improving outcomes in lung cancer. The emergence of the coronavirus pandemic posed unprecedented challenges, with impacts felt across the entire care pathway from presentation to diagnosis and access to treatment. Objective(s): To compare referrals and outcomes for key stages in the lung cancer pathway over a 3 month period before and after implementation of national lockdown due to the coronavirus pandemic.

Method(s)
Retrospective analysis of all suspected lung cancer referrals received before (1st January - 22nd March 2020) and after (23rd March- 30th June 2020) national lockdown was implemented, examining route of referral, stage, proportion with histologic confirmation, WHO performance status (PS), time to diagnosis, treatment modality and 62 day breaches.

Result(s)
In early April, the lung cancer service adapted to the pressures of the pandemic: a retired chest physician returned to support the lung cancer service and daily ad-hoc virtual clinics were introduced. Bronchoscopy, EBUS and radiology capacity was maintained by implementing new "Covid-secure"protocols. IT infrastructure was upgraded to support virtual lung MDTs. During lockdown, there was a 45% reduction in overall referrals and a 15% increase in emergency referrals (Table 1). There was a 7.6% increase in patients presenting with stage III disease with a corresponding reduction in stage II disease. Time to first appointment, diagnosis and treatment reduced significantly post-lockdown. Overall, 7% fewer patients had radical treatment mainly due to reduced surgery, but more patients had chemotherapy and radiotherapy during the lockdown period.

Conclusion(s)
The lung cancer service adapted to the pressures of the coronavirus pandemic to maintain timely diagnosis and treatment for patients with lung cancer. Nevertheless 7% fewer patients had radical treatment. The Trust will continue to monitor and adapt the lung cancer service in light of further waves of the coronavirus pandemic.

 

Malhotra, P; McIntosh, A; Murphy, P; Peers, V. (2021). Impact of the coronavirus pandemic and national lockdown on a lung cancer service – opportunities for innovation. Lung Cancer. 156 (Suppl 1), S8

 

« Back