Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba 261-0002, Japan; Department of Public Health, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
Department of Health Research, Chiba Foundation for Health Promotion and Disease Prevention, 32-14 Shin-Minato, Mihama-ku, Chiba 261-0002, Japan.
Cancer Epidemiol. 2024 Jun;90:102549. doi: 10.1016/j.canep.2024.102549. Epub 2024 Mar 5.
The coronavirus disease 2019 pandemic prompted healthcare providers to use different approaches from the current standards of care. We aimed to identify the changes in the number of treatments for primary non-small cell lung cancer (NSCLC) and metastatic lung cancer during the pandemic.
We used nationwide insurance claims data from January 2015 to January 2021, and estimated changes in the number of treatments using an interrupted time series analysis.
The number of surgical resections for primary NSCLC significantly decreased in April 2020 (-888; 95% confidence interval [CI]: -1530 to -246) and July 2020 (-1314; 95% CI: -1935 to -694), while the number of stereotactic body radiotherapies (SBRTs) increased in April 2020 (95; 95% CI: 8-182) and July 2020 (111; 95% CI: 24-198). The total number of treatments for primary NSCLC remained unchanged; however, non-significant decreases were observed in 2020. The number of surgical resections for metastatic lung cancer significantly decreased in April 2020 (-201; 95% CI: -337 to -65), but it eventually increased in July 2020 (170; 95% CI: 32-308). Additionally, the number of SBRTs significantly increased in April 2020 (37; 95% CI: 3-71) and October 2020 (57; 95% CI: 23-91). The total number of treatments for metastatic lung cancer was maintained, with an initial decrease in April 2020 followed by a subsequent increase in July and October 2020.
In Japan, surgical triage for primary and metastatic lung cancer are likely to have been implemented during the pandemic. Despite these proactive measures, patients with primary NSCLC may have been untreated, likely owing to their undiagnosed disease, potentially leading to a deterioration in prognosis. By contrast, patients diagnosed with cancer prior to the pandemic are presumed to have received standard management throughout the course of the pandemic.
2019 年冠状病毒病大流行促使医疗保健提供者采用不同于当前护理标准的方法。我们旨在确定大流行期间原发性非小细胞肺癌（NSCLC）和转移性肺癌治疗数量的变化。
我们使用了 2015 年 1 月至 2021 年 1 月的全国性保险索赔数据，并使用中断时间序列分析来估计治疗数量的变化。
2020 年 4 月（-888；95%置信区间[CI]：-1530 至-246）和 7 月（-1314；95%CI：-1935 至-694），原发性 NSCLC 的手术切除数量显著减少，而立体定向体放射治疗（SBRT）的数量在 2020 年 4 月（95；95%CI：8-182）和 7 月（111；95%CI：24-198）增加。原发性 NSCLC 的总治疗数量保持不变；然而，2020 年观察到非显著减少。转移性肺癌的手术切除数量在 2020 年 4 月（-201；95%CI：-337 至-65）显著减少，但最终在 7 月增加（170；95%CI：32-308）。此外，2020 年 4 月（37；95%CI：3-71）和 10 月（57；95%CI：23-91）SBRT 的数量显著增加。转移性肺癌的总治疗数量保持不变，2020 年 4 月最初减少，随后 7 月和 10 月增加。
在日本，原发性和转移性肺癌的手术分类可能在大流行期间实施。尽管采取了这些积极措施，但原发性 NSCLC 患者可能未得到治疗，可能是因为他们的疾病未被诊断出来，这可能导致预后恶化。相比之下，在大流行前被诊断出患有癌症的患者在整个大流行期间被认为接受了标准治疗。
