Objective:To quantify the extent of the disruption and recovery of lung cancer detection during the first two years of the pandemic, focusing on disparities across demographic and community factors.Methods:This retrospective cohort study used the SEER database to identify lung cancer cases from 2001 to 2021. Expected incidence rates for 2020 and 2021 were projected based on pre-pandemic trends (2000–2019) using the NCI’s Joinpoint Regression program. Percent differences between expected and observed incidence rates were calculated. Multivariate and propensity score analyses were conducted to quantify changes in the odds of being diagnosed with metastatic disease during the pandemic.Results:Lung cancer incidence fell by 10% in 2020 compared to pre-pandemic projections, with rural populations, non-Hispanic Black and Asian patients, and females disproportionately affected. By 2021, detection rates partially recovered but remained 5% below expected levels. Localized disease detection improved significantly, while rural communities not adjacent to metropolitan areas faced further declines. Adjusted analyses showed that patients with small-cell lung cancer (SCLC) and those of Hispanic, non-Hispanic Black, or Asian/Pacific Islander ethnicity had persistently higher rates of distant disease presentation through 2021.Conclusions:The pandemic significantly reduced lung cancer detection, with only partial recovery by 2021. Persistent gaps, particularly in rural and minoritized populations, highlight the need for targeted interventions to reengage these communities.
目的：量化新冠大流行前两年期间肺癌检测的中断与恢复程度，重点关注人口统计学和社区因素间的差异。 方法：本回顾性队列研究利用SEER数据库识别2001年至2021年的肺癌病例。基于大流行前趋势（2000–2019年），使用美国国家癌症研究所的Joinpoint回归程序预测2020年和2021年的预期发病率，并计算预期与观察发病率之间的百分比差异。通过多变量分析和倾向性评分分析，量化大流行期间诊断为转移性疾病的几率变化。 结果：与疫情前预测相比，2020年肺癌发病率下降10%，其中农村居民、非西班牙裔黑人和亚裔患者以及女性群体受影响尤为严重。至2021年，检测率部分恢复但仍低于预期水平5%。局部病变检测显著改善，但非都市毗邻农村地区的检测率进一步下降。校正分析显示，小细胞肺癌患者以及西班牙裔、非西班牙裔黑人或亚裔/太平洋岛民族群直至2021年仍持续呈现更高的远处转移疾病发生率。 结论：新冠大流行显著降低了肺癌检出率，至2021年仅部分恢复。持续存在的差距，特别是在农村和少数族裔群体中，凸显了需要采取针对性干预措施以重新激活这些群体的筛查参与。
肿瘤(癌症)患者之家