The Covid-19 pandemic has caused significant disruption to healthcare services and delivery worldwide. The impact of the pandemic and associated national lockdowns on lung cancer incidence in England has yet to be assessed.

What was the impact of the first year of the Covid-19 pandemic on the incidence and presentation of lung cancer in England?

In this retrospective observational study, incidence rates (IR) for lung cancer were calculated from The National Lung Cancer Audit (NLCA) Rapid Cancer Registration Datasets for 2019 and 2020, using mid-year population estimates from the Office of National Statistics as the denominators. Rates were compared using Poisson regression according to time points related to national lockdowns in 2020.

64457 patients were diagnosed with lung cancer across 2019 (n = 33088) and 2020 (n = 31369). During the first national lockdown, there was a 26% reduction in lung cancer incidence compared to the equivalent calendar period of 2019 (adjusted IRR 0.74, 95% CI 0.71 to 0.78). This included a 23% reduction in non-small cell lung cancer (NSCLC) (adjusted IRR 0.77, 95% CI 0.74 to 0.81) and a 45% reduction in small cell lung cancer (SCLC) (adjusted IRR 0.55, 95% CI 0.46 to 0.65) incidence. Incidence rates almost recovered thereafter to baseline, without overcompensation (adjusted IRR 0.96, 95% CI 0.94 to 0.98).

The incidence rates of lung cancer in England fell significantly by 26% during the first national lockdown in 2020, and did not compensate later in the year.