COVID-19 大流行对全世界的医疗保健系统产生了重大影响，包括肺癌患者的护理。医疗保健中断和行为改变对肺癌死亡率的影响尚不清楚。将 2020-2021 年大流行期间新诊断出的肺癌患者与 2018-2019 年大流行前诊断的患者进行比较。主要结局是一年内的全因死亡率。进行 Cox 比例风险回归分析来估计大流行和大流行前之间的死亡率变化。进行多重中介分析以确定导致死亡率变化的因素。这项研究总共纳入了 5785 名肺癌患者。与大流行前相比，大流行期间的总体死亡率显着升高（粗风险比[HR]：1.19，95%置信区间[CI]：1.05，1.29）。中介分析显示，未接受肿瘤定向治疗、诊断年龄较大以及癌症筛查诊断率下降显着占17.5%（95%CI：4.2、30.7）、13.9%（95%CI：0.8、27.0）、死亡率分别增加 12.4% (95%CI: 3.0, 21.8)。这项研究显示，尽管随访状态存在潜在的选择偏倚，但未接受肿瘤定向治疗或癌症筛查的肺癌患者的死亡风险显着增加。应重点确保及时获得医疗保健服务，优化治疗服务，并解决肺癌患者在大流行期间面临的独特挑战，以减轻大流行对肺癌结果的影响，并为弱势群体提供临床护理。© 2024 作者。约翰·威利出版的《国际癌症杂志》

COVID-19 pandemic has had a substantial effect on healthcare systems worldwide, including the care of patients with lung cancer. The impact of healthcare disruptions and behavioral changes on lung cancer mortality is unclear. Patients newly diagnosed with lung cancer during the pandemic period 2020-2021 were compared with those diagnosed in the pre-pandemic 2018-2019. The primary outcome was all-cause mortality within 1 year. Cox proportional hazards regression analyses were conducted to estimate the changes in mortality between pandemic and pre-pandemic. Multiple mediation analyses were performed to determine the factors that accounted for the changes in mortality. In total, 5785 patients with lung cancer were included in this study. The overall mortality rate was significantly higher during the pandemic compared with the pre-pandemic (crude hazard ratio [HR]: 1.19, 95% confidence interval [CI]: 1.05, 1.29). Mediation analyses showed that not receiving tumor-directed treatment, diagnosis at an older age, and decreased diagnosis through cancer screening significantly accounted for 17.5% (95%CI: 4.2, 30.7), 13.9% (95%CI: 0.8, 27.0), and 12.4% (95%CI: 3.0, 21.8) of the increased mortality, respectively. This study revealed a significant increase in mortality risk in patients with lung cancer who have not received tumor-directed treatment or cancer screening, despite potential selection bias for follow-up status. Efforts should be focused on ensuring timely access to healthcare services, optimizing treatment delivery, and addressing the unique challenges faced by patients with lung cancer during the pandemic to mitigate the impact of the pandemic on lung cancer outcomes and provide clinical care to vulnerable populations.© 2024 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.