# Impact of the COVID-19 Pandemic on the Diagnosis of Malignant Neoplasia of the Bronchus and Lung in the Burgos Region

## TL;DR

This study examines how the COVID-19 pandemic affected lung cancer diagnosis and survival in the Burgos region, finding fewer diagnoses and shorter survival times during the pandemic.

## Contribution

The study provides new insights into the impact of the pandemic on lung cancer detection and outcomes, emphasizing the need for improved non-pharmacological strategies during health crises.

## Key findings

- Fewer patients were diagnosed with lung cancer during the pandemic period compared to the pre-pandemic period.
- Patients diagnosed after the pandemic onset had shorter survival times, especially those in stage IV.
- Stage I patients diagnosed before the pandemic had significantly longer survival times than others.

## Abstract

Purpose: To retrospectively analyze the impact of the COVID-19 pandemic on the diagnosis, mortality rate, and survival period of malignant bronchial and lung neoplasms in the Burgos region, with the aim of promoting the development of strategies to improve cancer care management during health crises, highlighting the importance of non-pharmacological approaches to mitigate the negative impacts of future pandemics on lung cancer patients. Methods: This retrospective, longitudinal, single-center study was conducted in Burgos from 2019 to 2021. Participants included all patients diagnosed with malignant bronchial and lung neoplasms by the Pneumology unit of Complejo Asistencial Universitario de Burgos during the year immediately before and the year immediately after 31 March 2020, the official start date of the pandemic. Inclusion criteria encompassed patients diagnosed through histological or clinicoradiological methods, who provided informed consent. Data were systematically gathered using a specific template that included demographic information, disease stage, death, and survival time. Statistical analysis involved descriptive methods, ANOVA, and chi-square tests to assess differences in survival time and associations between categorical variables. Results: The results reveal a decrease in the number of patients diagnosed during the pandemic period (154 vs. 105), which could indicate delays in detection. However, there were no significant differences between the two periods, in which more than 60% of cases were detected in stage IV, being incompatible with survival. Although fewer patients died during the pandemic than expected (p = 0.015), patients diagnosed after the onset of the pandemic had a shorter survival time (182.43 ± 142.63 vs. 253.61 ± 224.30; p = 0.038). Specifically, those diagnosed in stage I during the pre-pandemic had a much longer survival time (741.50 days) than the rest of the patients (p < 0.05). In addition, among those diagnosed in stage IV, those diagnosed after the beginning of the pandemic had a shorter survival time (157.29 ± 202.36 vs. 241.18 ± 218.36; p = 0.026). Conclusions: Understanding these changes can support both medical strategies and non-pharmacological therapies to improve cancer care management during health crises, thus contributing to the optimization of public health.