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. 2022 Mar;29(3):1629-1635.
doi: 10.1245/s10434-021-11086-8. Epub 2021 Nov 19.

COVID-19 is Affecting the Presentation and Treatment of Melanoma Patients in the Northeastern United States

Catherine H Davis  1   2 , Jason Ho  2 , Stephanie H Greco  3 , Vadim P Koshenkov  1   2 , Roberto J Vidri  3 , Jeffrey M Farma  3 , Adam C Berger  4   5
Affiliations

COVID-19 is Affecting the Presentation and Treatment of Melanoma Patients in the Northeastern United States

Catherine H Davis et al. Ann Surg Oncol. 2022 Mar.

Abstract

Background: Covid-19 significantly affected healthcare delivery over the past year, with a shift in focus away from nonurgent care. Emerging data are showing that screening for breast and colon cancer has dramatically decreased. It is unknown whether the same trend has affected patients with melanoma.

Methods: This is a retrospective cohort study of melanoma patients at two large-volume cancer centers. Patients were compared for 8 months before and after the lockdown. Outcomes focused on delay in treatment and possible resultant upstaging of melanoma.

Results: A total of 375 patients were treated pre-lockdown and 313 patients were treated post-lockdown (17% decrease). Fewer patients presented with in situ disease post-lockdown (15.3% vs. 17.9%), and a higher proportion presented with stage III-IV melanoma (11.2% vs. 9.9%). Comparing patients presenting 2 months before versus 2 months after the lockdown, there was an even more significant increase in Stage III-IV melanoma from 7.1% to 27.5% (p < 0.0001). Finally, in Stage IIIB-IIID patients, there was a decrease in patients receiving adjuvant therapy in the post lockdown period (20.0% vs. 15.2%).

Conclusions: As a result of the recent pandemic, it appears there has been a shift away from melanoma in situ and toward more advanced disease, which may have significant downstream effects on prognosis and could be due to a delay in screening. Significantly patients have presented after the lockdown, and fewer patients are undergoing the recommended adjuvant therapies. Patient outreach efforts are essential to ensure that patients continue to receive preventative medical care and screening as the pandemic continues.

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Figures

Fig. 1
Fig. 1
Melanoma growth with diagnostic or treatment delay (adapted from Tejera et al.)
See this image and copyright information in PMC

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