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

Mynard, Nathan; Saxena, Ashish; Mavracick, Alexandra; Port, Jeffrey; Lee, Benjamin; Harrison, Sebron; Chow, Oliver; Villena-Vargas, Jonathan; Scheff, Ronald; Giaccone, Giuseppe; Altorki, Nasser

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. METHODS: : We conducted a retrospective review of a prospective database of lung cancer patients at our institution from July 1(st), 2019 until March 31(st), 2021. Patients were grouped by calendar year quarter in which they received care. Basic demographics and clinical staging were compared across quarters. RESULTS: : 554 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=0.004). 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=0.026). CONCLUSIONS: : After a transient but significant increase in Stage I/II disease with easing of restriction 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.