The Impact of Delays during the Pandemic Months on Survival of Lung Cancer Patients in Canada in 2020

Background and Purpose: Most cancer deaths in the world are due to lung cancer and diagnosis and treatment delays sharply reduce survival in lung cancer patients. This study examined the impact of delays during the early months of the pandemic on the survival of newly identified lung cancer patients in Canada in 2020. Method: This was a secondary data analysis from published literature and openly available data sources. Cancer Statistics from existing literature were used as a proxy for the month-wise distribution of lung cancer cases in Canada. The incidence of lung cancer, using population statistics from Statistics Canada and incidence rates from the Canadian Cancer Statistics in 2020, was estimated. The population-based Excel model employed compounded cuts on the incidence to arrive at the outcomes. Plotdigitzer.com tool was used to digitize the survival versus time curves for each stage from secondary sources. Stage-wise incidences for each sex were calculated for each age group for each month of 2020. Using delay impact on each stage the final results were calculated. Results: A total of 5004 life years would have been lost due to 448 deaths in the long term (40 months) attributed to the delays caused during March, April, May and June in Canada. The estimated incidence for all stages of lung cancer for these months was 9801 although the observed incidence was expected to be 6571 due to reduced screenings. Hence, it was within the missing 3231 cases that delays would occur. Over the short term (10 months) there are expected to be 151 early deaths and 273 deaths in the intermediate-term (20 months). Conclusions: This study using a mathematical model showed that in 2020, the COVID epidemic resulted in higher mortality and fewer lung cancer diagnoses in Canada. As a result of the delays in assessment, screening, and treatment that accompanied the pandemic lockdowns, there has been a rise in total life years lost due to lung cancer, demonstrating the pandemic’s huge impact on lung cancer patients.