# The Impact of the COVID-19 Pandemic on Diagnosis, Treatment, and Survival of Lung Cancer Patients in Thailand from 2019–2021

## TL;DR

The study found that the COVID-19 pandemic slightly reduced new lung cancer diagnoses in Thailand but did not significantly affect patient characteristics or survival rates, thanks to maintained healthcare policies.

## Contribution

This study provides empirical evidence on how the pandemic affected lung cancer care in Thailand, highlighting healthcare system adaptability.

## Key findings

- The pandemic caused a 13% to 17% decline in new lung cancer diagnoses.
- Early-stage non-small cell lung cancer cases increased by 1.3 to 2.2 times during the pandemic.
- One-year survival rates remained consistent despite the pandemic.

## Abstract

Background/Objectives: The COVID-19 pandemic emerged in early 2020, disrupting global cancer services. We aimed to assess the pandemic’s impact on lung cancer diagnosis and treatment, including clinical characteristics, diagnostic methods, treatment patterns, and survival outcomes. Methods: A retrospective analysis of 1832 patients visiting Maharaj Nakorn Chiang Mai Hospital from January 2019 to December 2021 with suspected lung cancer was conducted. We evaluated demographic characteristics, diagnostic methods, treatment modalities, and survival results across this period. Results: Among the 698 eligible patients, the pandemic led to a 13% to 17% decline in newly diagnosed lung cancer cases. However, demographic and lung cancer characteristics, including age, gender, and smoking status, remained unchanged. The pandemic also saw an increase in asymptomatic cases and a 1.3 to 2.2 times higher occurrence of early-stage non-small cell lung cancer cases. The rapid implementation of healthcare policies prioritized the diagnosis of suspected cancer patients and maintained cancer care throughout the pandemic, resulting in similar diagnostic methods and waiting times compared to the pre-pandemic era. Treatment patterns displayed continuity, with a notable rise in 2 to 3 times higher surgical interventions and an 8% to 11% decrease in the initial delivery of palliative care. The delivery of systemic therapy for patients with advanced-stage disease was also maintained. One-year survival rates remained consistent across various lung cancer stages during the pandemic. Conclusions: The COVID-19 pandemic led to a modest decrease in new diagnoses, with limited effects on the demographic and clinical profiles of lung cancer cases. Survival rates among patients diagnosed during the pandemic remained stable compared to those diagnosed before the pandemic. These findings underscore the adaptability of the healthcare system, alongside the capabilities of multidisciplinary teams, in providing timely and effective diagnosis and ensuring uninterrupted essential treatment of lung cancer during challenging circumstances.