Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2023

COVID-19 impacts on lung cancer diagnosis, management and timeliness in Victoria, Australia: A population based observational study (#404)

Luc te Marvelde 1 2 , Margaret Brand 3 , Udani Himalsha 3 , Shantelle Smith 3 , Sue M Evans 1 , John R Zalcberg 4 5 , Rob G Stirling 6 7
  1. Victorian Cancer Registry, Cancer Council Victoria, Melbourne, VIC, Australia
  2. School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
  3. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
  4. Cancer Research Program, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  5. Dept of Medical Oncology, Alfred Health, Melbourne, Victoria, Australia
  6. Allergy Immunology and Respiratory Medicine, Alfred Health, Monash University, Melbourne, VIC, Australia
  7. Central Clinical School, Faculty of Medicine, Monash University, Melbourne, Victoria, Australia

Aims: To describe impact of COVID-19 on lung cancer incidence, stage at diagnosis, treatment utilisation and timeliness of care in Victoria, Australia. 

 

Methods: Retrospective study using population wide Victorian Cancer Registry data and clinical data from the Victorian Lung Cancer Registry, comparing data pre-COVID (01 Jan 2019 to 31 Mar 2020) with the COVID era (01 Apr 2020 to 31 Dec 2021). Population wide data on 9,857 lung cancer diagnoses diagnosed from 2019 to 2021 in Victorian residents, and 5,984 cases with additional clinical data.

 

Results: Between Q2 2020 and end of 2021, 282 (95% CI = 190 – 374) fewer Victorians (127 (95%CI 63-190) males and 154 females (95%CI 88-222)) were diagnosed with lung cancer than expected. No differences were detected in clinical stage at diagnosis following the COVID-19 restrictions. No statistical difference was found in the proportion of patients receiving treatment comparing the COVID period (86.5%) with the pre-COVID period (88.0%; OR =  0.87 [0.75 - 1.02]). The proportion of patients receiving a diagnosis within ≤28 days of referral was similar in the COVID period (69.4%) compared with the pre-COVID period (69.1%; OR = 1.02 [0.91 - 1.14]). No differences were found between the proportion of cases who commenced treatment <= 42 days of referral between the pre-COVID and COVID period. Overall, timeliness measures were more likely to be met by younger patients. Time to treatment targets were less likely to be met for patients residing out of the major cities.

 

Conclusions: Compared to the expected number of diagnoses, 4.1% fewer lung cancer diagnoses were observed in 2020 and 2021 combined. Although the healthcare system in Victoria had many disruptions following COVID restrictions, no major negative impacts on treatment utilisation nor timeliness were observed.