EFFECT OF THE COVID 19 PANDEMIC ON EARLY DIAGNOSIS OF LUNG CANCER

Background: Lung cancer remains the leading cause of cancer death in the world and one of the most lethal cancers in humans. This is a reflection of several factors such as the frequent presence of comorbidities (smoking patients), advanced age and late diagnosis of the disease. In Brazil, up to 75% of cases are diagnosed with metastatic disease. Although screening with low-dose radiation tomography is able to reduce the mortality of the disease, its implementation is a challenge and there is no national program. The COVID19 pandemic led to an increase in the number of chest CT scans performed in the emergency services, due to respiratory symptoms. The hypothesis of this study is that with the increase in the number of CT scans, there has been an increase in the proportion of lung cancer diagnosed at an early-stage (I/II). Methods: All non-small-cell lung cancer (NSCLC) patients were selected from the data lake of a Brazilian private oncology group. The annual proportion of early-stage diagnosis was calculated for the years 2017 to 2022. Results: A total of 2,397 patients were included in the study [279 (2017); 303 (2018); 349 (2019); 445 (2020); 542 (2021); 479 (2022)]. The proportion of early-stage was 11%, 9.5%, 11%, 9.6%, 14.7% and 22% for the years 2017 to 2022 respectively. The proportion for the period of 2017-2019 was 10.6% and for the period of 2020-2022 was 15.6% (p<0.01). Conclusion: This is the first Brazilian data showing an increase in the proportion of early cases of lung cancer, possibly due to the wider use of CT scans performed in emergency services during the COVID19 pandemic. From 2017 to 2022 there was a 100% increase in the proportion of stage I/II cases. These data suggest that there is a portion of Brazilian patients with potentially diagnosable early-stage lung cancer who could benefit from a low-dose radiation tomography screening program.