Lung Cancer Mortality, Early Diagnosis During COVID-19 Pandemic

Despite improvements in access to innovative lung cancer treatments in Brazil, significant disparities in access to health care in the country remain, and lung cancer ranks as the fourth most common type of cancer. Further, the COVID-19 pandemic raised concerns that any progress made in the past decades may have been hindered, exacerbating challenges Brazil already faces in fighting lung cancer. Results of an ecological study covering the period from 2000 to 2020, with secondary data regarding lung cancer gathered from Brazil’s public health system, were presented at WCLC 2023 in Singapore.

Both mortality, which was adjusted by the World Health Organization’s standard population, and hospital admission rates were calculated per 100,000 inhabitants and stratified by sex. Linear regression was performed to define time trends, and Spearman correlation was used to evaluate the association between mortality and smoking rates. A micro-costing analysis was done to estimate the budgetary impact caused by the change in the staging of diagnosis due to the COVID-19 pandemic.

Results of the study showed that between 2000 and 2020 a reduction in age-adjusted lung cancer mortality among the male population was observed, but the opposite was seen among women. A positive association between mortality and smoking was also noted among men but was inversely proportional for women. Mortality also decreased in more developed regions of Brazil (eg, southeast and south) but increased in less developed regions (eg, north and northeast). Study findings also showed a progressive increase in lung cancer hospitalizations over the years but decreased in 2020-2021, along with a decline in adjusted mortality, likely due to the COVID-19 pandemic. During the same time period (2020-2021), although no greater delay in starting treatment was observed, a decrease in early diagnosis of lung cancer was noted among patients with private health insurance (–19%) and among women (–33%), a change that has the potential to increase the cost of care.

Source: Maselli-Schoueri JH, Fonseca Magalhães Filho MA, Aguiar Jr P, et al. Lung cancer mortality in Brazil: temporal trends, regional disparities, and the impact of the COVID-19 pandemic. Abstract of a poster presented at the 2023 World Conference on Lung Cancer; September 9-12, 2023; Singapore.