OBJECTIVES: Healthcare professionals have emphasized that the COVID-19 pandemic has resulted in significant gaps in the number of new cancer diagnosis. The French HTA estimated that 30,000 cases were undiagnosed in France between March and May 2020.¹ Lung cancer is a public health issue as it was responsible for 21% of all cancer deaths in 2018.² It is associated with a fast progression and metastatic potency. The objective of this study was to describe the recent evolution of the number of patients with metastatic lung cancer (mLC) in France, by considering the patients’ characteristics and health center’s localization.

METHODS: This is a retrospective study based on the French national claims hospitals database (PMSI), covering all public and private care centers in France. All hospitalizations from January 2018 to December 2020 with ICD-10 codes for lung cancer (C34) combined with at least one metastasis code (C77, C78, C79) were extracted to identify adult patients with mLC.

RESULTS: Overall, 81,532 mLC patients were identified with a mean age of 66 years (± 10.4), and 34.6% female. Between 2018 and 2020, the number of patients diagnosed for mLC decreased by 21.0% (n=29,697 vs n=23,485). This decrease was different according to the demographic characteristic of patients (23.1% for men vs 16.9% for women; 26.9% for patients aged between 50 and 70 vs 16.9% for patients under 50 and 21.1% for those over 70) and ranging between 16.8% in the Nouvelle-Aquitaine region to 26.8% in the Île-de-France region. Men aged 50-70 years were the sub-population most affected by the decrease in mLC diagnoses in most regions.

CONCLUSIONS: This study showed a gap in diagnosis of mLC in 2020 underlining the impact of the COVID-19 pandemic on the hospital care system. This observed gap varied by age, gender and region.