P32 Impact of the COVID-19 pandemic on health equality in malignant melanoma diagnosis

Abstract

Abstract Difficult access to care during the COVID-19 pandemic has led to a delay in some disease diagnoses. The pandemic has exacerbated pre-existing health inequalities, and the most deprived population has often been the most disproportionately affected. In this study, we investigated the impact of COVID-19 on the volume and pattern of melanoma diagnosis, to evaluate whether there is an association with the socioeconomic status of the population. Cases with newly diagnosed cutaneous melanoma from January 2019 to December 2021 were identified in a specialist multidisciplinary team-held database. Breslow thickness, pathological disease stage, patient demographics and postcodes were reviewed. In the 3-year study period, there was a total of 1910 cases. Compared with 2019 prepandemic data, there was a 31% reduction (P = 0.03) in melanoma cases diagnosed in 2020 and a 10% reduction (P = 0.09) in 2021. In 2020, stage 4 cases had a 46% increase (P = 0.031). In 2019, 7% of the most deprived population had stage 4 disease at diagnosis, which increased to 21% in 2020 (P = 0.02). COVID-19 has caused a dramatic reduction in the volume of melanoma diagnoses and an accompanying upstage of disease. Among the most deprived population in our region, they are three times more likely to receive a stage 4 diagnosis vs. before the pandemic. This suggests that the barrier to health care secondary to the pandemic is most apparent to the deprived population and probably caused a delay in cancer diagnosis among this group of patients. Health policy needs to be put in place urgently to address this health inequality, to minimize the prognostic impact on the population.