Effects of COVID-19 Lockdown on Melanoma Diagnosis in Switzerland: Increased Tumor Thickness in Elderly Females and Shift towards Stage IV Melanoma during Lockdown.

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License: CC BY 4.0
Serval ID
serval:BIB_48374EA25FBD
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Effects of COVID-19 Lockdown on Melanoma Diagnosis in Switzerland: Increased Tumor Thickness in Elderly Females and Shift towards Stage IV Melanoma during Lockdown.
Journal
Cancers
Author(s)
Kostner L., Cerminara S.E., Pamplona GSP, Maul J.T., Dummer R., Ramelyte E., Mangana J., Wagner N.B., Cozzio A., Kreiter S., Kogler A., Streit M., Wysocki A., Zippelius A., Läubli H., Navarini A.A., Maul L.V.
ISSN
2072-6694 (Print)
ISSN-L
2072-6694
Publication state
Published
Issued date
10/05/2022
Peer-reviewed
Oui
Volume
14
Number
10
Pages
2360
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
At the early stages of the COVID-19 outbreak in 2020, Switzerland was among the countries with the highest number of SARS-CoV2-infections per capita in the world. Lockdowns had a remarkable impact on primary care access and resulted in postponed cancer screenings. The aim of this study was to investigate the effects of the COVID-19 lockdown on the diagnosis of melanomas and stage of melanomas at diagnosis. In this retrospective, exploratory cohort study, 1240 patients with a new diagnosis of melanoma were analyzed at five tertiary care hospitals in German-speaking Switzerland over a period of two years and three months. We compared the pre-lockdown (01/FEB/19-15/MAR/20, n = 655) with the lockdown (16/MAR/20-22/JUN/20, n = 148) and post-lockdown period (23/JUN/20-30/APR/21, n = 437) by evaluating patients' demographics and prognostic features using Breslow thickness, ulceration, subtype, and stages. We observed a short-term, two-week rise in melanoma diagnoses after the major lift of social lockdown restrictions. The difference of mean Breslow thicknesses was significantly greater in older females during the lockdown compared to the pre-lockdown (1.9 ± 1.3 mm, p = 0.03) and post-lockdown period (1.9 ± 1.3 mm, p = 0.048). Thickness increase was driven by nodular melanomas (2.9 ± 1.3 mm, p = 0.0021; resp. 2.6 ± 1.3 mm, p = 0.008). A proportional rise of advanced melanomas was observed during lockdown (p = 0.047). The findings provide clinically relevant insights into lockdown-related gender- and age-dependent effects on melanoma diagnosis. Our data highlight a stable course in new melanomas with a lower-than-expected increase in the post-lockdown period. The lockdown period led to a greater thickness in elderly women driven by nodular melanomas and a proportional shift towards stage IV melanoma. We intend to raise awareness for individual cancer care in future pandemic management strategies.
Keywords
Breslow thickness, COVID-19, age, diagnostic delay, gender, lockdown, melanoma
Pubmed
Web of science
Open Access
Yes
Create date
17/06/2022 13:57
Last modification date
23/01/2024 8:24
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