Putting off lung cancer surgery for more than three months can increase the likelihood of recurrence and shorten survival—an important consideration, as many surgeries have been put on hold due to COVID-19.

Varun Puri, MD, of the Washington University School of Medicine, and colleagues looked at 9,904 people receiving care through the Veterans Health Administration who were diagnosed with Stage I non-small-cell lung cancer and underwent surgery between 2006 and 2016. The average time between diagnosis and surgery was 70 days. Black people and those in low income areas had longer delays.

Over six years of follow-up, 42% experienced recurrence. Beyond a 12-week window after diagnosis, the risk of relapse rose by 0.4% with each extra week. What’s more, patients who received surgery within the first 12 weeks lived 7.5 months longer than those who waited.