Impact of the COVID-19 pandemic on lung cancer diagnosis, treatment, mortality, and survival in Belgium: A population-based study - 02/10/25
, Hanna M. Peacock a, Geert Silversmit a, Thierry Berghmans b, Paul De Leyn c, Ingel Demedts d, Xavier Geets e, Yolande Lievens f, Harlinde De Schutter a
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Highlights |
• | A higher proportion of patients was diagnosed with metastatic disease;. |
• | No increase in untreated patients or in time-to-treatment;. |
• | Surgery decreased in favour of radiotherapy for early-stage patients;. |
• | Increase in unadjusted 90-day post-operative mortality;. |
• | No decrease in 3-year relative survival. |
Abstract |
Background |
We evaluated the impact of COVID-19 on the care pathway and outcomes for patients diagnosed with lung cancer in 2020 in Belgium.
Methods |
Lung cancer patients diagnosed in 2017–2020 were extracted from the nationwide Belgian Cancer Registry database. Characteristics and treatment of patients in 2020 were compared with 2017–2019 at semester level (January-June: S1; July-December: S2). 90-day post-operative mortality and relative survival (RS) at 1 and 3 years for 2020 were compared with the 2017–2019 trend.
Results |
The study included 29,721 patients diagnosed with lung cancer in 2017–2020. Patients diagnosed in 2020 had a poorer WHO Performance status and more often distant metastases compared to the corresponding semester in 2017–2019. In 2020 S2, there was slightly less surgery performed in patients with early-stage (I-II) lung cancer in favour of radiotherapy (RT) (surgery:4.7 percent-points, RT +6.0 percent-points, p = 0.001). RT courses had a shorter median duration (S1:4 days; S2:4 days) and lower median number of fractions (S1:5; S2:5). The unadjusted 90-day post-operative mortality increased, but this increase was no longer significant when adjusting for case-mix (unadjusted: Odds ratio (OR) =1.85 [1.05–3.24]; adjusted: (OR 1.78 [0.99–3.21]). There was no significant change in RS at 1 and 3 years, with or without case-mix adjustment (unadjusted: 1-year excess hazard ratio (EHR)=1.06 [1.00–1.12], 3-year EHR=1.05 [1.00–1.11]; adjusted: 1-year EHR=1.02 [0.96–1.08], 3-year EHR=1.02 [0.96–1.07]).
Conclusion |
Lung cancer patients in Belgium experienced only minor changes in their care pathway during the COVID-19 pandemic. The changes in stage distribution and the increase in 90-day postoperative mortality warrant monitoring of long-term outcomes.
Il testo completo di questo articolo è disponibile in PDF.Keywords : COVID-19, Lung cancer, Time-to-treatment, Post-operative mortality, Relative survival
Abbreviations : BCR, cStage, EHR, ICD-10, IMA, IQR, NSCLC, NSSN, OR, p, RS, S1, S2, WHO-PS
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Vol 88
Articolo 101205- novembre 2025 Ritorno al numero
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