DP07 The effect of the COVID-19 pandemic on the Breslow thickness of melanoma at presentation

Abstract

Abstract The COVID-19 pandemic has caused significant disruption in dermatology healthcare due to patient concern over attending appointments, their conscious effort not to overwhelm services and, in many areas, reduced access to clinical care in the community. This was a single-centre service evaluation of the thickness and staging of melanomas presenting to a secondary care dermatology unit, before, during and after the COVID-19 pandemic. The primary aim was to assess whether there was an increase in tumour thickness and melanoma stage in newly referred patients diagnosed with melanoma postpandemic vs. those presenting prepandemic. Melanoma staging and tumour thickness data were extracted from the local histopathology database for all patients with a melanoma diagnosed at a new patient clinic appointment during the years 2018–2019, 2020–2021 and 2021–2022. Data were subsequently tabulated and analysed. Seventy-five malignant melanomas were identified from 2018 to 2019, with a mean (SD) tumour thickness of 1.47 (2.16) mm. From 2020 to 2021, 93 melanomas were identified with a mean (SD) tumour thickness of 2.17 (3.13) mm. Between 2021 and 2022, 121 melanomas were identified with a mean (SD) tumour thickness of 1.58 (2.70) mm. The mean increase in melanoma thickness between 2018–2019 and 2020–2021 was 0.70 mm (P = 0.10). There was an increase in thicker and higher-stage melanomas diagnosed in 2020–2021, 27 of stage 3A–4C, vs. 17 in 2018–2019 (P = 0.35). Comparing prepandemic lesions with postpandemic ones, the overall number of lesion diagnoses increased from 75 to 121; however, there has not been a statistically significant change in mean thickness (P = 0.77) or the number of higher-grade lesions seen (P = 0.58). In conclusion, there was an increase in the average tumour thickness and melanoma staging immediately after the height of the COVID-19 pandemic. This resonates with published data examining the impact of COVID-19 on melanoma diagnosis from the USA (Weston GK, Jeong HS, Mu EW et al. Impact of COVID-19 on melanoma diagnosis. Melanoma Res 2021; 31:280–1). Further data will be extracted to assess if patient demographics and history for the duration of the presenting lesion correlated with delay in presentation and thicker lesions. It would be interesting to compare data from other dermatology units to see whether there is a similar trend and to collate the patients’ outcomes to evaluate whether patients with delayed presentation have worse prognoses.