Pleural mesothelioma incidence and use of systemic treatment decreased during the COVID-19 pandemic in The Netherlands

Pleural mesothelioma (PM) is a lethal cancer often linked to asbestos exposure. The COVID-19 pandemic caused a global health crisis, raising concerns about its impact on cancer diagnoses and treatments. In response to the immense pressures on the healthcare system caused by the COVID-19 pandemic, many countries advised prioritizing essential healthcare services while postponing or suspending care considered non-emergent to prevent overburdening healthcare systems. This study assesses the impact of COVID-19 on the incidence, treatment, and overall survival of PM patients in the Netherlands between 2018 and 2022. Data were collected from the Netherlands Cancer Registry for 2,629 PM patients. Incidence, treatment patterns, and survival rates were analyzed using statistical methods, including Kruskal–Wallis and log-rank tests. PM incidence dropped 13.2% in 2020 during the pandemic, with a 58.8% increase in patients receiving best supportive care and a decline in chemotherapy use (from 39.4% to 32.0%). In 2021, diagnoses rebounded (+ 15.2%), and immunotherapy use rose following its approval. However, no significant difference in overall survival was found between 2018 and 2022. COVID-19 led to a temporary decline in PM diagnoses and systemic treatments in 2020, followed by recovery in 2021. Despite these changes, overall survival rates remained stable.