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Background <p>The coronavirus disease 2019 (COVID-19) pandemic imposed substantial challenges on healthcare systems worldwide, significantly influencing the diagnosis, treatment processes, and clinical outcomes of patients with lung cancer. This article aims to evaluate the indirect oncological consequences of the pandemic, with particular emphasis on delays in diagnosis, staging, and surgical treatment from a thoracic surgery perspective.</p> Methods <p>During the pandemic, extensive structural and administrative transformations were implemented in hospitals, including reorganization of clinical services, allocation of dedicated COVID-19 units, postponement of elective procedures, and redistribution of healthcare resources. While these measures were essential for infection control, they significantly limited access to routine oncological care. This study was designed as a narrative review. Literature was searched in PubMed databases for studies published between January 2020 and February 2026 using combinations of the terms “COVID-19”, “lung cancer”, “thoracic surgery”, “delay diagnosis”. English-language articles evaluating the impact of the pandemic on lung cancer diagnosis, staging, treatment, and outcomes were included. Relevant studies were selected based on clinical relevance and methodological quality. Case reports were excluded from the study as exclusion criteria.</p> Results <p>Evidence from multiple international studies demonstrates substantial reductions in lung cancer diagnoses, decreased surgical volumes, prolonged referral and treatment intervals, and a shift toward more advanced disease stages at presentation. Screening interruptions, patient reluctance to seek medical attention, and restricted diagnostic procedures contributed to a global “diagnostic deficit.” Although surgical outcomes remained generally safe when appropriate protective protocols were applied, treatment delays and altered therapeutic strategies, including increased use of radiotherapy and systemic therapies, raised concerns regarding long-term oncological outcomes. Overall, the pandemic highlighted the vulnerability of cancer care systems during global health crises while also demonstrating that continuity of thoracic oncology services can be maintained through structured protocols and dedicated pathways.</p> Conclusion <p>These findings underscore the necessity of developing resilient healthcare systems capable of preserving timely cancer diagnosis and treatment during future pandemics to minimize indirect mortality and loss of life-years among lung cancer patients.</p>

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The indirect oncological burden of the COVID-19 pandemic: global disruptions in lung cancer diagnosis, surgical management, and healthcare system resilience — a narrative review

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月16日

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  • Rasih Yazkan,
  • Hasan Ekrem Camas,
  • Suleyman Emre Akin

摘要

Background

The coronavirus disease 2019 (COVID-19) pandemic imposed substantial challenges on healthcare systems worldwide, significantly influencing the diagnosis, treatment processes, and clinical outcomes of patients with lung cancer. This article aims to evaluate the indirect oncological consequences of the pandemic, with particular emphasis on delays in diagnosis, staging, and surgical treatment from a thoracic surgery perspective.

Methods

During the pandemic, extensive structural and administrative transformations were implemented in hospitals, including reorganization of clinical services, allocation of dedicated COVID-19 units, postponement of elective procedures, and redistribution of healthcare resources. While these measures were essential for infection control, they significantly limited access to routine oncological care. This study was designed as a narrative review. Literature was searched in PubMed databases for studies published between January 2020 and February 2026 using combinations of the terms “COVID-19”, “lung cancer”, “thoracic surgery”, “delay diagnosis”. English-language articles evaluating the impact of the pandemic on lung cancer diagnosis, staging, treatment, and outcomes were included. Relevant studies were selected based on clinical relevance and methodological quality. Case reports were excluded from the study as exclusion criteria.

Results

Evidence from multiple international studies demonstrates substantial reductions in lung cancer diagnoses, decreased surgical volumes, prolonged referral and treatment intervals, and a shift toward more advanced disease stages at presentation. Screening interruptions, patient reluctance to seek medical attention, and restricted diagnostic procedures contributed to a global “diagnostic deficit.” Although surgical outcomes remained generally safe when appropriate protective protocols were applied, treatment delays and altered therapeutic strategies, including increased use of radiotherapy and systemic therapies, raised concerns regarding long-term oncological outcomes. Overall, the pandemic highlighted the vulnerability of cancer care systems during global health crises while also demonstrating that continuity of thoracic oncology services can be maintained through structured protocols and dedicated pathways.

Conclusion

These findings underscore the necessity of developing resilient healthcare systems capable of preserving timely cancer diagnosis and treatment during future pandemics to minimize indirect mortality and loss of life-years among lung cancer patients.