{"doi":"10.21037/jtd-24-1334","title":"Continued implications of the COVID-19 pandemic environment on non-small cell lung cancer characteristics and treatment in the United States","abstract":"Background: Given the continued disruption of the coronavirus disease 2019 (COVID-19) pandemic throughout 2021, we aimed to assess for continued implications of the altered healthcare landscape on non-small cell lung cancer (NSCLC) presentation and treatment in the second year of the pandemic. Methods: This was a retrospective cohort study using the United States National Cancer Database (2019-2021). Demographic, cancer-related, and treatment variables were compared between patients diagnosed in the pre-pandemic year [2019], pandemic-year-one [2020], and pandemic-year-two [2021]. Multivariate logistic regression was performed to control for the impact of demographics on oncologic variables, and then for the impact of oncologic variables on treatment modalities and outcomes. Results: Of 376,193 NSCLC cases, 135,649 (36.1%) were pre-pandemic, 119,338 (31.7%) were pandemic-year-one, and 121,206 (32.2%) were pandemic-year-two. Compared to the pre-pandemic year, patients diagnosed in pandemic-year-two had risk-adjusted increases in clinical T stage [odds ratio (OR) =1.017; 95% confidence-interval (CI): 1.003-1.031], N stage (OR =1.048; 95% CI: 1.033-1.063), M stage (OR =1.044; 95% CI: 1.028-1.060), and overall stage (OR =1.038; 95% CI: 1.023-1.052). Additionally, compared to the pre-pandemic year, patients diagnosed in pandemic-year-two continue to see risk-adjusted increases in time from diagnosis to staging (OR =1.044; 95% CI: 1.017-1.072), to first treatment (OR =1.143; 95% CI: 1.133-1.154), to surgery (OR =1.117; 95% CI: 1.093-1.141) and to systemic therapy (OR =1.021; 95% CI: 1.924-1.039). Conclusions: Compared to the pre-pandemic year, patients diagnosed with NSCLC in the United States during pandemic-year-two continue to present at later clinical stage and experience delays to treatment. The oncologic and treatment characteristics of NSCLC have not returned to pre-pandemic baseline in the United States, possibly due to compounding delays to diagnosis and treatment and a growing back log of cases.","journal":"Journal of Thoracic Disease","year":2025,"id":533182,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":2,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6771,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":666335,"name":"Nicole M. Mott","orcid":"0000-0003-4834-3400","position":1,"is_corresponding":false},{"id":375948,"name":"Michael R. Bronsert","orcid":"0000-0003-1879-6193","position":2,"is_corresponding":false},{"id":1074768,"name":"Adam R. Dyas","orcid":"0000-0002-2136-8010","position":3,"is_corresponding":false},{"id":1023910,"name":"Salvador Rodriguez Franco","orcid":"0000-0001-9786-3651","position":4,"is_corresponding":false},{"id":332487,"name":"Ana Gleisner","orcid":"0000-0002-5040-4105","position":5,"is_corresponding":false},{"id":772351,"name":"Simran Randhawa","orcid":"0000-0002-5234-7108","position":6,"is_corresponding":false},{"id":491169,"name":"Elizabeth A. David","orcid":null,"position":7,"is_corresponding":false},{"id":980080,"name":"John Mitchell","orcid":"0000-0001-6087-5210","position":8,"is_corresponding":false},{"id":432107,"name":"Robert A. Meguid","orcid":"0000-0003-2646-4252","position":9,"is_corresponding":false},{"id":1074767,"name":"Christina M. Stuart","orcid":"0000-0002-9851-8486","position":0,"is_corresponding":true}],"reference_count":0,"raw_metadata":null,"created_at":"2026-07-19T02:51:32.301795Z","pmid":"39975727","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}