Health system strengthening recommendations for Lung Cancer Care: Lessons from the COVID-19 Pandemic

We explore how the COVID-19 pandemic amplified barriers across the lung cancer care continuum in Mexico. Drawing from a cross-sectional qualitative arm of a mixed methods study (N = 46), interviews were conducted with lung cancer patients at the Mexican National Cancer Institute between 2020-2021. Using thematic analysis, patients reported care delays due to fear of infection, unclear communication, and service disruptions. Thematic patterns revealed that these challenges were compounded by financial hardship, emotional distress, and reluctance to seek care. Key policy and practice implications include the need for flexible healthcare delivery models, improved communication strategies, financial support mechanisms, tailored interventions for care-seeking behaviours, and integrated mental health and community support. These findings underscore the urgency for systemic adaptations to safeguard timely cancer care during future health crises, particularly in middle-income settings like Mexico. Ethical approval was obtained from the Mexican National Cancer Institute. Lung cancer patients participated in structured interviews on symptom recognition, healthcare-seeking behaviour, and the impact of the COVID-19 pandemic. Interviews were analysed thematically using Braun and Clarke's framework. The following themes arose.