The Coronavirus Disease Pandemic 2019 [COVID-19]: Impact on NHS England PET-CT Scanning 

Purpose: To examine the impact of the COVID-19 pandemic on PET-CT scanning activity across England. Methods: Monthly PET-CT scanning activity was collected from 41/48 NHS England provider sites. Data from 31/41sites was stratified by non-oncology/oncology and cancer type. Lung cancer and lymphoma activity was split into specific indications. The data was compiled in Excel and analysed using Stata software to assess distribution and statistical significance of variation in activity comparing levels before and during the COVID-19 pandemic. Results: In April and May 2020 a 32% and 31% decrease in activity was observed; a larger decrease for non-cancer compared with cancer PET-CT. In June 2020 PET-CT activity started to recover with 6% fewer scans recorded compared with June 2019. Decrease and recovery varied according to cancer types. Of the six most common indications for PET CT, lung and oesophageal cancer had the largest decrease in activity: lung -29%, -45% and oesophagus -43%, -59% in April and May respectively, and slowest recovery, -23%, -26% respectively in June. By contrast, lymphoma and melanoma showed the smallest decrease: lymphoma -14%, -9%; melanoma -16%, +5% in April and May respectively, and fastest recovery +12% lymphoma +14% respectively. Specifically, lung cancer PET-CTs related to initial diagnosis and staging saw the largest fall and slowest recovery compared with PET-CTs for people with known lung cancer. Conclusions: There was considerable variation in the rate of decline and recovery in PET-CT scanning across cancer types and specific indications related to the cancer type. The causes for the variation remain to be explained.