Kettering General Hospital NHS Foundation Trust, Kettering, UK.
Department of Respiratory Sciences, University of Leicester, Leicester, UK, and consultant in respiratory medicine, Kettering General Hospital NHS Foundation Trust, Kettering, UK
Clin Med (Lond). 2023 Jan;23(1):38-44. doi: 10.7861/clinmed.2022-0201.
'Stage shift' has been proposed as a marker of impact of Coronavirus 2019 (COVID-19) in lung cancer services; however, there are no data available specifically from income-deprived areas. Thus, this study evaluated the impact of the COVID-19 pandemic on lung cancer care in our area (Corby; among the most income deprived in England) and identified focus recovery areas. The study was a retrospective observational study of 668 consecutive patients with lung cancer at a district general hospital, pre-, during and after the COVID peak. Outcomes were the overall number of cases, presenting staging and treatment pathway. Overall, 32 fewer patients were diagnosed during the pandemic, with more inpatient diagnoses (p=0.01) and fewer primary care referrals (p<0.0001). There were no differences observed in treatment intent or 'stage shift'. Our results suggest that COVID-19 negatively affected the whole lung cancer pathway in our area. However, 'stage shift' might not be ideal to assess the impact of COVID-19 in income-deprived areas. Further studies will help the strategic rollout of a screening programme to identify patients with lung cancer earlier on in such areas.
“阶段转移”被提议作为 2019 年冠状病毒（COVID-19）对肺癌服务影响的标志物；然而，目前尚无来自贫困地区的具体数据。因此，本研究评估了 COVID-19 大流行对我们地区（科伯；英格兰最贫困地区之一）肺癌护理的影响，并确定了重点恢复领域。该研究是对一家地区综合医院的 668 例连续肺癌患者在 COVID-19 高峰期之前、期间和之后进行的回顾性观察研究。结果是总体病例数、分期和治疗途径。总体而言，大流行期间诊断出的患者减少了 32 例，住院诊断（p=0.01）更多，而初级保健转介（p<0.0001）更少。在治疗意向或“阶段转移”方面未观察到差异。我们的结果表明，COVID-19 对我们地区的整个肺癌途径产生了负面影响。然而，“阶段转移”可能不是评估 COVID-19 在贫困地区影响的理想方法。进一步的研究将有助于在这些地区制定一个筛选计划，以更早地发现肺癌患者。
