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Impact of the SARS-CoV-2 pandemic on lung cancer survival in England: an analysis of the rapid cancer registration dataset
  1. Helen Morgan1,
  2. Savannah Gysling1,
  3. Neal Navani2,
  4. David Baldwin1,3,
  5. Richard Hubbard1,
  6. Emma O’Dowd1,3
  1. 1Lifespan and Population Health Sciences, University of Nottingham, Nottingham, UK
  2. 2Respiratory Medicine, University College London, London, UK
  3. 3Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
  1. Correspondence to Dr Helen Morgan, Lifespan and Population Health Sciences, University of Nottingham, Nottingham NG5 1PB, UK; helen.morgan{at}


Early changes in lung cancer care can affect survival. Given the decrease in diagnosis during lockdowns, we calculated their impact on survival using National Lung Cancer Audit data. Percentage survival and HRs for death were compared between 2019 and lockdown periods of 2020. Decreased survival was observed from the first national lockdown onwards and within 90 days of diagnosis. HRs were highest for people diagnosed at the end of 2020 at 1.26 (95% CI 1.20 to 1.32) for death within 90 days and 1.51 (95% CI 1.42 to 1.60) for death between 91 and 270 days. Further work is needed on measures to mitigate this impact.

  • lung cancer
  • clinical epidemiology
  • COVID-19

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  • Contributors HM was involved in study design, performed the majority of data processing and analysis, and drafted the article with input from SG. The original idea was from DB, RH, NN and EOD, who also contributed to design of the study and interpretation of the data. All authors were involved in revising the manuscript and approved its submission.

  • Funding This study was funded by Roy Castle Lung Cancer Foundation (Grant number: RB48HD).

  • Competing interests DB reports grants from Cancer Research UK, personal fees from Roche, personal fees from Astra Zeneca, personal fees from MSD, personal fees from BMS, outside the submitted work. RH reports personal fees from Galapagos, outside the submitted work. NN is supported by an MRC Clinical Academic Research Partnership (MR/T02481X/1). NN has received fees or non-financial support from Amgen, Astra Zeneca, Bristol-Meyers Squibb, Lilly & Co, Merck Sharp and Dohme, Olympus, Oncimmune, OncLive, PeerVoice, Pfizer and Takeda, outside of the submitted work.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.