Abstract:

The COVID-19 pandemic has brought unprecedented challenges in healthcare delivery. Speculation has been made regarding the effect of delaying care for many conditions due to national lockdown, fear among patients about visiting a healthcare facility, and a possible lack of recognition of conditions due to social isolation. The effect of diagnostic delay of melanoma in the United States has not yet been formally assessed. We retrospectively reviewed all melanomas diagnosed in one academic institution during the first three months of 2019 and 2021 and recorded the Breslow depth at diagnosis and excision. 2019 was chosen as the baseline prior to the COVID-19 pandemic. 2021 was chosen for comparison due to the double peak of COVID cases during 2020, and the availability of personal protective equipment and vaccines, as well as a return to more normal in-person clinic staffing in 2021. Results showed 57 cases of melanoma diagnosed in 2019 (28 invasive cases (49%) and 29 in situ cases (51%)). In 2021, 82 cases of melanoma were diagnosed (45 invasive cases (55%) and 27 in situ cases (45%)). The average Breslow depth was 1.1 mm in 2019 and 1.51 mm in 2021. These results were compared using a student T test to assess the difference in Breslow depth between the two years and chi square test to assess the difference in proportion that were invasive versus in situ between the two years. A statistically significant difference in the presence or the level of invasion was not found (proportion invasive versus in situ, p=.50; Breslow depth, p=0.52). Due to the strong correlation between Breslow depth and clinical stage at diagnosis, as well as overall mortality, our study demonstrates that the pandemic may not have had a significant negative impact on the overall outcome of newly diagnosed melanomas.

Financial Disclosure: No current or relevant financial relationships exist.

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Karen Trevino, MD