Continued implications of the COVID-19 pandemic environment on non-small cell lung cancer characteristics and treatment in the United States.

IF 2.1 3区医学 Q3 RESPIRATORY SYSTEM

Journal of thoracic disease Pub Date : 2025-01-24 Epub Date: 2025-01-22 DOI:10.21037/jtd-24-1334

Christina M Stuart, Nicole M Mott, Michael R Bronsert, Adam R Dyas, Salvador Rodriguez Franco, Ana L Gleisner, Simran K Randhawa, Elizabeth A David, John D Mitchell, Robert A Meguid

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引用次数: 0

Abstract

Background: Given the continued disruption of the coronavirus disease 2019 (COVID-19) pandemic throughout 2021, we aimed to assess for continued implications of the altered healthcare landscape on non-small cell lung cancer (NSCLC) presentation and treatment in the second year of the pandemic.

Methods: This was a retrospective cohort study using the United States National Cancer Database (2019-2021). Demographic, cancer-related, and treatment variables were compared between patients diagnosed in the pre-pandemic year [2019], pandemic-year-one [2020], and pandemic-year-two [2021]. Multivariate logistic regression was performed to control for the impact of demographics on oncologic variables, and then for the impact of oncologic variables on treatment modalities and outcomes.

Results: Of 376,193 NSCLC cases, 135,649 (36.1%) were pre-pandemic, 119,338 (31.7%) were pandemic-year-one, and 121,206 (32.2%) were pandemic-year-two. Compared to the pre-pandemic year, patients diagnosed in pandemic-year-two had risk-adjusted increases in clinical T stage [odds ratio (OR) =1.017; 95% confidence-interval (CI): 1.003-1.031], N stage (OR =1.048; 95% CI: 1.033-1.063), M stage (OR =1.044; 95% CI: 1.028-1.060), and overall stage (OR =1.038; 95% CI: 1.023-1.052). Additionally, compared to the pre-pandemic year, patients diagnosed in pandemic-year-two continue to see risk-adjusted increases in time from diagnosis to staging (OR =1.044; 95% CI: 1.017-1.072), to first treatment (OR =1.143; 95% CI: 1.133-1.154), to surgery (OR =1.117; 95% CI: 1.093-1.141) and to systemic therapy (OR =1.021; 95% CI: 1.924-1.039).

Conclusions: Compared to the pre-pandemic year, patients diagnosed with NSCLC in the United States during pandemic-year-two continue to present at later clinical stage and experience delays to treatment. The oncologic and treatment characteristics of NSCLC have not returned to pre-pandemic baseline in the United States, possibly due to compounding delays to diagnosis and treatment and a growing back log of cases.

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2019冠状病毒病大流行环境对美国非小细胞肺癌特征和治疗的持续影响

背景：鉴于2019冠状病毒病（COVID-19）大流行在整个2021年持续中断，我们的目的是评估在大流行的第二年，医疗格局的改变对非小细胞肺癌（NSCLC）的表现和治疗的持续影响。方法：这是一项使用美国国家癌症数据库（2019-2021）的回顾性队列研究。比较大流行前一年[2019]、大流行第一年[2020]和大流行第二年[2021]诊断的患者的人口学、癌症相关和治疗变量。采用多变量逻辑回归控制人口统计学对肿瘤变量的影响，然后控制肿瘤变量对治疗方式和结果的影响。结果：在376193例NSCLC病例中，135649例（36.1%）为大流行前，119338例（31.7%）为大流行第一年，121206例（32.2%）为大流行第二年。与大流行前一年相比，在大流行第二年确诊的患者经风险调整后临床T期增加[优势比(OR) =1.017；95%置信区间（CI）： 1.003-1.031]， N期(OR =1.048；95% CI: 1.033-1.063)， M期(OR =1.044；95% CI: 1.028-1.060)和总分期(OR =1.038；95% ci: 1.023-1.052)。此外，与大流行前一年相比，在大流行第二年确诊的患者从诊断到分期的时间继续出现经风险调整后的增加(OR =1.044；95% CI: 1.017-1.072)与首次治疗(OR =1.143；95% CI: 1.133-1.154)，到手术(OR =1.117；95% CI: 1.093-1.141)和全身治疗(OR =1.021；95% ci: 1.924-1.039)。结论：与大流行前一年相比，美国在大流行第二年诊断为NSCLC的患者继续出现在较晚的临床阶段，并经历治疗延迟。在美国，非小细胞肺癌的肿瘤学和治疗特征尚未恢复到大流行前的基线，可能是由于诊断和治疗的延误和病例的不断增加。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of thoracic disease RESPIRATORY SYSTEM-

CiteScore

4.60

自引率

4.00%

发文量

254

期刊介绍： The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.