A drop in lung cancer CT screenings at the beginning of the pandemic has been linked to a rise in malignancies by researchers at the University of Cincinnati.

"We have to make sure, as health care providers, that we're taking care of patients who have COVID-19, along with the rest of the population who don't have COVID-19, and that those two patient populations can safely coexist and receive treatment,” said lead author Dr. Robert Van Haren, an assistant professor and thoracic surgeon at the University of Cincinnati College of Medicine and a member of Cincinnati Research in Outcomes and Safety in Surgery (CROSS) within the department of surgery, in a statement.

The team compared monthly visits for LDCT screenings for lung cancer during the three months in which COVID-19 restrictions were in place to the number of monthly visits in the last three years. Having suspended LDCT in March, the institution saw 800 scans cancelled during this time. The university saw an average of 39 LDCT exams in March to June compared to 146 a month before the pandemic broke out.
Following a phased re-opening in May and a full one in June, scanned patient volume was still down, as were the number of new patients being scanned for lung cancer, with new patient monthly averages falling from 56 to 15. The no-show rate also increased, from 15% before restrictions to 40% afterward.

Upon starting up operations fully in June, 29% of patients had suspected malignancies, compared to 8% before COVID-19. This led more to be referred for biopsy or surgery as their suspected cancer entered a more critical phase. Van Haren says these numbers are probably due to concerns about coming to hospital during the pandemic, though this fear was not looked at specifically in the study.

"We've done two things to try to deal with that situation," he said. "One was that we made operational changes to ensure that screening is safe, and we made a big emphasis within our program and with our nurses and coordinators to educate patients about those changes and to really get the message out that screening is safe."

The study was selected for the 2020 Southern Surgical Association Program and has been published in the Journal of the American College of Surgeons online in advance of print.

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