Understanding the long-lasting impact of the COVID-19 pandemic on the diagnosis and management of lung cancer: a retrospective community hospital experience

Background: Cancer care was negatively affected during the COVID-19 pandemic. We sought to examine the long-term effects of the COVID-19 pandemic on patterns of lung cancer care among patients undergoing surgical resection at our thoracic surgery program. Methods: We conducted a retrospective cohort study of all patients who underwent lung resection for cancer at Michael Garron Hospital between 2018 and 2024. We categorized patients into 3 cohorts: prepandemic (2018 to 2019), COVID-19 pandemic (2020 to 2022), and postpandemic (2023 to 2024). We analyzed demographic characteristics, time to surgery, length of stay, multimodal treatment, and pathological stage. Results: We included 1090 patients. The time from consent to surgery was shorter in the pandemic cohort (26 v. 29 d; p < 0.01). Length of stay was also shorter during the pandemic and postpandemic periods (median 2 v. 3 d; p < 0.001). A higher proportion of patients presented with advanced-stage lung cancer (stage III) in the prepandemic cohort than in the other cohorts (15% v. 9%, p < 0.05). Conclusion: We found no significant delays in surgical care for lung cancer during the COVID-19 pandemic. Timelines to surgery may have been expedited owing to increased resource allocation. Through further study of adaptive mechanisms used during the pandemic, we can continue to provide increasingly effective and efficient lung cancer care.