COVID-19 pandemisinin akciğer kanseri teşhisine etkisi
Amaç: Akciğer kanseri, dünyada bildirilen en yüksek kanser ölüm oranına sahiptir. Hastane başvuruları, COVID-19 pandemisi sırasında sokağa çıkma kısıtlamalarından etkilenmiştir. Bu çalışmanın amacı, COVID-19 pandemisinin akciğer kanseri tanı sürecine etkisini araştırmaktır.
Yöntemler: Türkiye'deki ilk resmi COVID-19 vakasının ardından kliniğimize başvuran ve bronkoskopi ve/veya endobronşiyal ultrason ile yeni akciğer kanseri tanısı konulan ve COVID-19 pandemisinden önceki on dört ay içinde tanı konulan hastalar geriye dönük olarak incelendi.
Bulgular: Çalışmaya yaş ortalaması 64,4 ± 8,9 yıl, %89,6'sı erkek, 197 pandemi öncesi ve 139'u pandemi sırasında olan toplam 336 yeni akciğer kanseri hastası dahil edildi. Bu çalışmada, hastaların %17,6'sı karantina kapanmaları sırasında hastaneye başvurmuştur. Pandemi sırasında yeni tanı almış akciğer kanseri hastalarının ortanca yaşı daha genç, sigara içme oranı daha yüksek, öksürük ile başvuru oranı daha düşük (p=0.010), hemoptizi oranı daha yüksek (p=0.012), T evresi (p=0.008) artmış ve N evresi (p=0,001) N evresi azalmıştı. Karantinada gruplar arasında akciğer kanseri evrelemesi açısından anlamlı bir fark yoktu. Pandemi ve pandemi öncesi gruplar arasında metastaz oranlarında anlamlı bir fark yoktu. Pandemi sırasında akciğer kanseri hastalarında komorbidite oranı azaldı, kanser cerrahisi oranı değişmedi ancak kemoterapi oranı azaldı.
Sonuç: Pandemi sırasında yeni teşhis edilen akciğer kanseri vakalarının sayısı azaldı. Pandemi sırasında T ve N evreleri değişti. Akciğer kanseri için hastalık yükü ve tanı gecikmelerinin gelecekte artması beklenmektedir.
The impact of the COVID-19 pandemic on the lung cancer diagnosis
Objective: Hospital admissions have been affected by lockdowns during the COVID-19 pandemic. The purpose of this study is to investigate the impact of the COVID-19 pandemic on the lung cancer diagnosis process.
Methods: Patients who attended our clinic after the first official case of COVID-19 in Turkey were diagnosed with new lung cancer via bronchoscopy and/or endobronchial ultrasound, and were diagnosed during the fifteen months preceding the COVID-19 pandemic were analyzed retrospectively.
Results: A total of 336 lung cancer patients with a mean age of 64.4±8.9 years, 89.6% male, 197 pre-pandemic, and 139 during the pandemic were included in the study. In this study, 17.6% of the patients applied to the hospital during the lockdown. During the pandemic, the median age of patients was younger, the smoking rate was higher, the rate of admissions with cough was lower (p=0.010), the hemoptysis rate was higher (p=0.012), T stage (p=0.008) increased, and N stage (p=0.001) decreased in newly diagnosed lung cancer patients. There was no significant difference in lung cancer staging between the groups in lockdown. There was no significant difference in metastatic rates between the pandemic and pre-pandemic groups. During the pandemic, the rate of comorbidities decreased in lung cancer patients. The rate of cancer surgery did not change, but the rate of chemotherapy decreased during the pandemic.
Conclusions: The number of newly diagnosed lung cancer cases decreased, and stages changed during the pandemic. Lung cancer diagnosis delays and disease burden are expected to rise in the future.
___
- 1. Timeline of the COVID-19 pandemic in Turkey [Internet]. Wikipedia. 2021 [cited 2022 Dec 18]; Available from:
https://en.wikipedia.org/w/index.php?title=Timeline_of_the_COVID-19_pandemic_in_Turkey&oldid=1036646556
- 2. WHO Coronavirus (COVID-19) Dashboard [Internet]. [cited 2022 Dec 18];
Available from: https://covid19.who.int
- 3. Cancer [Internet]. [cited 2022 Mar 2];
Available from:
https://www.who.int/news-room/fact-sheets/detail/cancer
- 4. Duma N, Santana-Davila R, Molina JR. Non-Small Cell Lung Cancer: Epidemiology, Screening, Diagnosis, and Treatment. Mayo Clin Proc 2019;94(8):1623-40.
https://doi.org/10.1016/j.mayocp.2019.01.013
- 5. International Association for the Study of Lung Cancer (IASLC) Study of the Impact of COVID-19 on International Lung Cancer Clinical Trials | Elsevier Enhanced Reader [Internet]. [cited 2022 Apr 5];
Available from:
https://reader.elsevier.com/reader/sd/pii/S1556086422000867?token=63FC6AF12093CE7F6AF377075BE2C1B6383F8DE044953B08F9AFF9FCCB9B8D90391AAD189E215A7F6064AA6DC6AC01C5&originRegion=eu-west-1&originCreation=20220405084350
6. 65 Yaş ve Üstü ile Kronik Rahatsızlığı Olanlara Sokağa Çıkma Yasağı Genelgesi [Internet]. [cited 2022 Apr 4];
Available from:
https://www.icisleri.gov.tr/65-yas-ve-ustu-ile-kronik-rahatsizligi-olanlara-sokaga-cikma-yasagi-genelgesi
- 7. Sha Z, Chang K, Mi J, et al. The impact of the COVID-19 pandemic on lung cancer patients. Ann Palliat Med 2020;9(5):3373-3378.
https://doi.org/10.21037/apm-20-1662
- 8. Maringe C, Spicer J, Morris M, et al. The impact of the COVID-19 pandemic on cancer deaths due to delays in diagnosis in England, UK: a national, population-based, modelling study. Lancet Oncol 2020;21(8):1023-34.
https://doi.org/10.1016/S1470-2045(20)30388-0
- 9. Woolf SH, Chapman DA, Sabo RT, Weinberger DM, Hill L. Excess Deaths From COVID-19 and Other Causes, March-April 2020. JAMA 2020;324(5):510-513.
https://doi.org/10.1001/jama.2020.11787
- 10. Serra Mitjà P, Àvila M, García-Olivé I. Impact of the COVID-19 pandemic on lung cancer diagnosis and treatment. Med Clin (Engl Ed) 2022;158(3):138-9.
https://doi.org/10.1016/j.medcle.2021.07.009
- 11. Eskander A, Li Q, Yu J, et al. Incident Cancer Detection During the COVID-19 Pandemic. J Natl Compr Canc Netw 2022;1-9.
- 12. Zhang Y, Li J, Li Z-K, et al. Impact of Coronavirus Disease 2019 on Clinical Characteristics in Patients With Lung Cancer: A Large Single-Centre Retrospective Study. Front Oncol 2021;11:693002.
https://doi.org/10.3389/fonc.2021.693002
- 13. Kokturk N, Babayigit C, Kul S, et al. The predictors of COVID-19 mortality in a nationwide cohort of Turkish patients. Respir Med 2021;183:106433.
https://doi.org/10.1016/j.rmed.2021.106433
- 14. Young RP, Hopkins RJ, Christmas T, Black PN, Metcalf P, Gamble GD. COPD prevalence is increased in lung cancer, independent of age, sex and smoking history. Eur Respir J 2009;34(2):380-6.
https://doi.org/10.1183/09031936.00144208
- 15. Deboever N, Mitchell KG, Feldman HA, Cascone T, Sepesi B. Current Surgical Indications for Non-Small-Cell Lung Cancer. Cancers (Basel) 2022;14(5):1263.
https://doi.org/10.3390/cancers14051263
- 16. Kasymjanova G, Anwar A, Cohen V, et al. The Impact of COVID-19 on the Diagnosis and Treatment of Lung Cancer at a Canadian Academic Center: A Retrospective Chart Review. Curr Oncol 2021;28(6):4247-55.
https://doi.org/10.3390/curroncol28060360