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<p>COVID-19 led to canceled or delayed care in 2020 — with consequences.</p>

Delayed Screenings Correlate with More Severe Lung Cancer Malignancies

By Jonathan Springston, Editor, Relias Media

Researchers from one institution discovered a connection between fewer lung cancer screenings and a rise in cases of severe lung cancer malignancies.

At the University of Cincinnati, clinicians use low-dose computed tomography (LDCT) to screen for lung cancer, a technique considered efficacious for lowering the lung cancer mortality rate. Because of the COVID-19 pandemic, administrators paused all LDCT screens on March 13 before a phased reopening that started May 5, leading to a full reopen on June 1.

Between March 13 and June 1, 800 LDCT screens were canceled, and even when operations returned to close to normal, officials noted a decline in patients who presented for LDCT screens. Specifically, researchers found the institution averaged 146 LDCT screens per month before the pandemic started vs. an average of 39 per month in the March to June period.

When operations resumed in June, researchers observed 29% of patients with lung nodules suspicious for malignancy vs. 8% before the pandemic. In response, administrators have put a focus on providing more education to patients to help alleviate safety concerns. Additionally, the institution made several operational changes, including moving the LDCT screenings to an outpatient facility and spacing those appointments farther apart.

“We have to make sure as healthcare providers that we’re taking care of patients who have COVID-19 and along with the rest of the population who don’t have COVID-19, and that those two patient populations can safely co-exist and receive treatment,” Robert M. Van Haren, MD, MSPH, FACS, assistant professor and thoracic surgeon at the University of Cincinnati and lead author, said in a statement.

Although this study included observations made at a single facility, it fits with a pattern observed across the United States throughout the pandemic — namely, patients have been putting off preventive care over concerns about contracting COVID-19 in medical facilities.

Never-Smokers Can Develop Lung Cancer

Although tobacco smoking is a serious risk factor for developing lung cancer and dying from the disease, the authors of a recent analysis discovered 12 of 100 patients recently diagnosed with lung cancer in the United States never smoked tobacco.

This is a small sample size, but it could lead researchers to investigate other lung cancer causes closer, including exposure to secondhand smoke, hazardous materials (e.g., asbestos, cleaning chemicals), radon, and air pollution.

Personalized Radiation Therapy

For those with lung cancer, clinicians may treat with a rigid radiation therapy approach. However, a group of researchers recently found a combination of math and genomics can lead to a more personalized, targeted treatment approach for these patients.

“It’s standard of care to give patients the same radiation dose based on the type of cancer and its stage,” Javier F. Torres-Roca, MD, a senior member in the Radiation Oncology Program at Moffitt Cancer Center, said in a statement. “The idea that this is optimal for every patient is in direct conflict with the fact that all cancers are different. In this study, we demonstrate that the standard dose results in the majority of patients getting either too much or too little radiation. We developed a new technology that can personalize the dose required for a specific patient’s tumor biology and quantified the clinical opportunity this provides.”