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Disparities in Lung Cancer Diagnosis During the COVID-19 Pandemic in Western Pennsylvania

Gay, Emma (2023) Disparities in Lung Cancer Diagnosis During the COVID-19 Pandemic in Western Pennsylvania. Master Essay, University of Pittsburgh.

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Background/Objective: Lung cancer is the second most common cancer and leading cause of cancer-related death in Pennsylvania (PA). Prior to the COVID-19 pandemic, incidence rates in PA had been decreasing by 0.8% annually. PA entered a stay-at-home order on April 1, 2020 which ended June 4, 2020. The objective of this project was to assess the effects of the COVID-19 pandemic on lung cancer diagnoses with a focus on the initial lockdown period and rural-urban disparities.
Methods: Data for all lung cancer patients diagnosed at a UPMC Hillman Cancer Center in western PA in 2019 and 2020 was obtained from the UPMC Network Cancer Registry. Patients were excluded if missing age or sex, age ≤ 20, stage 0, not a PA resident, not actively followed, or received treatment out of state. Total number of cases diagnosed in each year were compared and stratified by month of diagnosis, residence, and stage at diagnosis. Descriptive and analytic statistics were performed using SAS; graphics were made using GraphPad.
Results: Patients diagnosed in 2020 did not significantly differ by age, sex, race, smoking history, histology or stage at diagnosis from those diagnosed in 2019. Overall, there were less lung cancer diagnoses in 2020 (n=1190) compared to 2019 (n=1316; p=0.01). Evaluation of the number of diagnoses per month by year showed declines during the months (April, May) corresponding to the stay-at-home order. When stratified by residence, no decrease in total number of diagnoses was observed among rural residents, but among urban residents notable declines were observed.
Conclusion: These preliminary analyses showed a noticeable drop in diagnoses during the initial lockdown period, and no increase during the second half of 2020 compared to the same period in 2019. The drop in total number of diagnoses in 2020 versus 2019 appears to be driven by a decline in diagnoses among urban residents. The rural-urban differences may be due to differing attitudes about the threat posed by COVID-19 and/or support of the stay-at-home order. Understanding the effects of the COVID-19 pandemic on cancer diagnoses and outcomes will help inform public health policy and practice for future pandemics.


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Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Gay, Emmaelg74@pitt.eduelg740000-0001-8152-7047
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairGlynn, Nancy W.epidnwg@pitt.eduepidnwgUNSPECIFIED
Committee MemberDiergaarde, Brendadiergaardeb@upmc.eduUNSPECIFIEDUNSPECIFIED
Committee MemberSoliman, Amrasoliman@med.cuny.eduUNSPECIFIEDUNSPECIFIED
Date: 5 January 2023
Date Type: Completion
Submission Date: 7 December 2022
Access Restriction: 2 year -- Restrict access to University of Pittsburgh for a period of 2 years.
Number of Pages: 52
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Epidemiology
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: Yes
Uncontrolled Keywords: surveillance, health equity, hospital, rural, urban, stage at diagnosis
Date Deposited: 05 Jan 2023 15:24
Last Modified: 05 Jan 2023 15:24


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