JOURNAL of
ONCOLOGICAL
SCIENCES

ORIGINAL RESEARCH ARTICLE

The Incidental Diagnosis of Lung Cancer Through Chest Tomography During the COVID-19 Pandemic
Received Date : 06 Jul 2023
Accepted Date : 24 Aug 2023
Available Online : 06 Sep 2023
Doi: 10.37047/jos.2023-98748 - Article's Language: EN
Journal of Oncological Sciences. 2023;9(3):152-7.
This is an open access article under the CC BY-NC-ND license
ABSTRACT
Objective: This study aims to determine the frequency of incidental lung cancers detected during chest computed tomography (CT) scans performed for guiding the diagnosis or treatment of coronavirus disease-2019 (COVID-19). Material and Methods: In this single- center retrospective study, the chest CT scans taken during the beginning of COVID-19 pneumonia (mostly pre-vaccination era) between April 2020 and December 2020 were examined. Patients who were younger than 18 years and those with a prior history of cancer were excluded. Moreover, the clinicopathological factors and radiologic findings of those patients with pulmonary nodule size on CT ≥3 mm or masses were recorded. Results: We assessed the CT scans of 2994 patients. A pulmonary nodule ≥3 mm or a mass was detected in 473 patients, while nine of them were diagnosed with lung cancer. The median age of lung cancer patients was 65 years (48-71 years). The most common subtype of lung cancer was adenocarcinoma (44.4%), followed by squamous cell carcinoma (33.3%) and small cell lung cancer (22.2%). Furthermore, all patients were diagnosed at the non-metastatic stage. Conclusion: Our study showed that early-stage lung cancers were detected incidentally on CT scans in suspected COVID-19 pneumonia patients. While the COVID-19 pandemic resulted in significant mortality worldwide, early diagnosis and treatment of these cases can save several lives.
REFERENCES
  1. Garg M, Prabhakar N, Bhalla AS, et al. Computed tomography chest in COVID-19: When & why? Indian J Med Res. 2021;153(1 & 2):86-92. [Crossref]  [PubMed]  [PMC] 
  2. T.C. Sağlık Bakanlığı [İnternet]. © 2023 T.C. Sağlık Bakanlığı [Erişim tarihi: 19 Mart 2023]. Günlük COVID-19 aşı tablosu. Erişim linki: [Link] 
  3. World Health Organization [Internet]. ©2023 WHO [Cited: March 19, 2022]. WHO coronavirus (COVID-19) dashboard. Available from: [Link] 
  4. Corman VM, Landt O, Kaiser M, et al. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill. 2020;25(3):2000045. Erratum in: Euro Surveill. 2020;25(14): Erratum in: Euro Surveill. 2020;25(30): Erratum in: Euro Surveill. 2021;26(5): [Crossref]  [PubMed]  [PMC] 
  5. Özkarafakılı MA, Özkurt H, Bardakçı Mİ, et al. Comparison of chest computed tomography findings of RT-PCR negative and RT-PCR positive cases in COVID-19 patients. Clin Imaging. Feb 2022;82:7-12. [Crossref]  [PubMed]  [PMC] 
  6. Jacobs PC, Mali WP, Grobbee DE, van der Graaf Y. Prevalence of incidental findings in computed tomographic screening of the chest: a systematic review. J Comput Assist Tomogr. 2008;32(2):214-221. [Crossref]  [PubMed] 
  7. National Cancer Institute [Internet]. [Cited: March 8, 2022]. Cancer Stat Facts: Common Cancer Sites. Available from: [Link] 
  8. Dinmohamed AG, Visser O, Verhoeven RHA, et al Fewer cancer diagnoses during the COVID-19 epidemic in the Netherlands. Lancet Oncol. 2020;21(6):750-751. Erratum in: Lancet Oncol. 2020: [Crossref]  [PubMed]  [PMC] 
  9. IQVIA [Internet]. ©2023 IQVIA. Shifts in healthcare demand, delivery and care during the COVID-19 era. 05.01.2023. Available from: [Link] 
  10. Sümbül A, Yalçin S, Özet A, et al. Turkish society of medical oncology covid-19 pandemic advisory board updated recommendations for medical oncologists: Included vaccination. Journal of Oncological Sciences. 2021;7(1):1-6. [Crossref] 
  11. American College of Radiology [Internet]. [Cited: ]. ACR Recommendations for the use of chest radiography and computed tomography (CT) for suspected COVID-19 infection. 29.04.2022 Available from: [Link] 
  12. de Koning HJ, van der Aalst CM, de Jong PA, et al. Reduced lung-cancer mortality with volume CT screening in a randomized trial. N Engl J Med. 2020;382(6):503-513. [Crossref]  [PubMed] 
  13. Dündar İ, Özkaçmaz S, Durmaz F, et al. Detection of incidental findings on chest CT scans in patients with suspected Covid-19 pneumonia. Eastern Journal of Medicine. 2021;26(4):566-574. [Crossref] 
  14. Ronit A, Kristensen T, Klitbo DM, et al. Incidental lung cancers and positive computed tomography images in people living with HIV. AIDS. 2017;31(14):1973-1977. [Crossref]  [PubMed] 
  15. Manser RL, Dodd M, Byrnes G, Irving LB, Campbell DA. Incidental lung cancers identified at coronial autopsy: implications for overdiagnosis of lung cancer by screening. Respir Med. 2005;99(4):501-507. [Crossref]  [PubMed] 
  16. Aberle DR, DeMello S, Berg CD, et al; National Lung Screening Trial Research Team. Results of the two incidence screenings in the National Lung Screening Trial. N Engl J Med. 2013;369(10):920-931. [Crossref]  [PubMed]  [PMC] 
  17. Field JK, Duffy SW, Baldwin DR, et al. UK lung cancer RCT pilot screening trial: baseline findings from the screening arm provide evidence for the potential implementation of lung cancer screening. Thorax. 2016;71(2):161-170. [Crossref]  [PubMed]  [PMC] 
  18. Travis WD, Brambilla E, Nicholson AG, et al; WHO Panel. The 2015 World Health Organization Classification of Lung Tumors: Impact of Genetic, Clinical and Radiologic Advances Since the 2004 Classification. J Thorac Oncol. 2015;10(9):1243-1260. [PubMed] 
  19. T.C. Sağlık Bakanlığı [İnternet]. ©2017 Halk Sağlığı Genel Müdürlüğü [Erişim tarihi: 23 Şubat 2023]. 2017 yili türkiye kanser istatistikleri. Erişim linki: [Link] 
  20. Jonas DE, Reuland DS, Reddy SM, et al. Screening for lung cancer with low-dose computed tomography: updated evidence report and systematic review for the US preventive services task force. JAMA. 2021;325(10):971-987. [Crossref]  [PubMed] 
  21. Hoffman RM, Atallah RP, Struble RD, Badgett RG. Lung cancer screening with low-dose CT: a meta-analysis. J Gen Intern Med. 2020;35(10):3015-3025. [Crossref]  [PubMed]  [PMC] 
  22. Quadrelli S, Lyons G, Colt H, Chimondeguy D, Buero A. Clinical characteristics and prognosis of incidentally detected lung cancers. Int J Surg Oncol. 2015;2015:287604. [Crossref]  [PubMed]  [PMC] 
  23. Yekedüz E, Karcıoğlu AM, Utkan G, Ürün Y. A clinical dilemma amid COVID-19 pandemic: missed or encountered diagnosis of cancer? Future Oncol. 2020;16(25):1879-1881. [Crossref]  [PubMed]  [PMC] 
  24. Goncalves S, Fong PC, Blokhina M. Artificial intelligence for early diagnosis of lung cancer through incidental nodule detection in low- and middle-income countries-acceleration during the COVID-19 pandemic but here to stay. Am J Cancer Res. 2022;12(1):1-16. [PubMed]  [PMC] 
  25. LeMense GP, Waller EA, Campbell C, Bowen T. Development and outcomes of a comprehensive multidisciplinary incidental lung nodule and lung cancer screening program. BMC Pulm Med. 2020;20(1):115. [Crossref]  [PubMed]  [PMC] 
  26. Kocher F, Lunger F, Seeber A, et al. Incidental diagnosis of asymptomatic non-small-cell lung cancer: a registry-based analysis. Clin Lung Cancer. 2016;17(1):62-67.e1. [Crossref]  [PubMed]