Delayed Diagnosis and Care of Skin Cancers in the Era of COVID-19
Posted: Thursday, February 4, 2021
The COVID-19 pandemic has led to a significant backlog in undiagnosed skin cancers and diagnostic delays of nearly 2 months, according to Justin W. Marson, MD, of the National Society for Cutaneous Medicine in New York, and colleagues. These findings were published in the Journal of the American Academy of Dermatology.
Researchers utilized data collected from outpatient chart reviews from 143 dermatology practices in the United States from January 2019 through August 2020. Data analysis focused on 350 providers caring for 4.7 million patients across 13 states. Diagnoses from 2020 were grouped as follows: before COVID-19 (January–February 2020), initial peak COVID-19 (March–May 2020), and COVID-19 recovery (June–August 2020).
The monthly average number of skin cancer diagnoses decreased during peak COVID-19 compared with before March 2020 and the initial recovery period. The largest decrease in diagnoses occurred in April 2020, with a 69.6% decrease in melanomas, a 77.7% decrease in squamous cell carcinoma, and an 85.9% decrease in basal cell carcinoma. Comparing June–August 2020 (when the impact of COVID-19 decreased) with June–August 2019, there was only a slight increase in skin cancer diagnoses (9.2% increase in melanoma, 3.1% increase in squamous cell carcinoma, 1.4% increase in basal cell carcinoma).
Overall, the total number of skin cancer diagnoses fell in 2020 compared with 2019 in this data set. There were 279 fewer melanomas diagnosed, 6,000 fewer squamous cell carcinomas, and 9,914 fewer basal cell carcinomas. According to the authors, this would mean an estimated 19,600 fewer melanomas, 421,300 fewer squamous cell carcinomas, and 696,100 fewer basal cell carcinomas within the U.S. population as a whole. The researchers estimated that even if these skin cancers were diagnosed at the first opportunity in the COVID-19 recovery period, there would be an average diagnostic delay of 1.8 months, 2.1 months, and 1.9 months for melanoma, squamous cell carcinoma, and basal cell carcinoma, respectively. This may lead to cancers presenting at more advanced stages, with potentially increased morbidity and mortality.
Disclosure: The study authors reported no conflicts of interest.