Table 2.

Cross-cutting themes and challenges in lung cancer care due to the COVID-19 pandemic.

(1) Patients and their interactions with healthcare professionals (HCPs)

(a) Trauma/stress for both patients and HCPs. Barriers to empathy and support for lung cancer patients

(b) Patient presentation and clinical assessment

(i) Delayed presentation of symptomatic and at-risk (‘shielding’) patients

(ii) Increased mortality risk of COVID-19 in patients at risk of or diagnosed with lung cancer, including patient factors (comorbidity/age/smoking) and treatments, including systemic chemotherapy and surgery

(iii) Risk–benefit and shared decision-making discussions between patients and HCPs (including safety netting)

(iv) Overlap in clinical features and investigations between lung cancer and COVID-19 (including radiology)

(v) Personal protective equipment (PPE) for assessment and treatment

(2) HCP and workforce issues

(a) Redeployment to COVID-19 services and reduced deployment if self-isolating or in shielding groups

(b) Burnout and stress

(c) Rapidly evolving evidence and guidelines

(3) Service design and delivery

(a) Pause/changes in service provision and rapid service redesign

(b) Rapid move to virtual clinics and MDTs, and challenges these poses

(c) Reduced capacity of services and diagnostic investigations (including imaging, respiratory physiology and bronchoscopy)

(d) Reduced recruitment to clinical trials