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Article

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

1
Department of Dermatology, University Hospital of Basel, 4031 Basel, Switzerland
2
Department of Ophthalmology, University of Lausanne, 1004 Lausanne, Switzerland
3
Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland
4
Department of Dermatology, University Hospital of Zurich, 8091 Zurich, Switzerland
5
Department of Dermatology, Cantonal Hospital of St. Gallen, 9000 St. Gallen, Switzerland
6
Department of Dermatology, Cantonal Hospital of Aarau, 5001 Aarau, Switzerland
7
Department of Dermatology, Cantonal Hospital of Lucerne, 6000 Lucerne, Switzerland
8
Department of Theragnostics, Division of Oncology, University Hospital Basel, 4031 Basel, Switzerland
9
Laboratory of Cancer Immunology and Immunotherapy, Department of Biomedicine, University of Basel, University Hospital of Basel, 4031 Basel, Switzerland
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Academic Editor: Jose Manuel Lopes
Cancers 2022, 14(10), 2360; https://doi.org/10.3390/cancers14102360
Received: 5 April 2022 / Revised: 29 April 2022 / Accepted: 6 May 2022 / Published: 10 May 2022
Concerns about potential diagnostic delays due to pandemic-related disruptions were expressed early during the COVID-19 outbreak. In the present study, we investigated the impact of the Swiss COVID-19 lockdown between March and June 2020 on newly diagnosed melanomas. Our main findings include a short-term rise in melanoma diagnoses after the major lift of social lockdown restrictions. Further, the analyzed prognostic factor for melanomas, the Breslow thickness, was greater in elderly female patients during the lockdown compared to the pre- and post-lockdown period. In addition, proportionally more stage IV melanomas were diagnosed during the lockdown period. Our study highlights the need for an adjusted management of cancer patients in future pandemic management strategies.
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. View Full-Text
Keywords: COVID-19; lockdown; melanoma; diagnostic delay; Breslow thickness; age; gender COVID-19; lockdown; melanoma; diagnostic delay; Breslow thickness; age; gender
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MDPI and ACS Style

Kostner, L.; Cerminara, S.E.; Pamplona, G.S.P.; 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. Effects of COVID-19 Lockdown on Melanoma Diagnosis in Switzerland: Increased Tumor Thickness in Elderly Females and Shift towards Stage IV Melanoma during Lockdown. Cancers 2022, 14, 2360. https://doi.org/10.3390/cancers14102360

AMA Style

Kostner L, Cerminara SE, Pamplona GSP, Maul J-T, Dummer R, Ramelyte E, Mangana J, Wagner NB, Cozzio A, Kreiter S, Kogler A, Streit M, Wysocki A, Zippelius A, Läubli H, Navarini AA, Maul LV. Effects of COVID-19 Lockdown on Melanoma Diagnosis in Switzerland: Increased Tumor Thickness in Elderly Females and Shift towards Stage IV Melanoma during Lockdown. Cancers. 2022; 14(10):2360. https://doi.org/10.3390/cancers14102360

Chicago/Turabian Style

Kostner, Lisa, Sara E. Cerminara, Gustavo S.P. Pamplona, Julia-Tatjana Maul, Reinhard Dummer, Egle Ramelyte, Johanna Mangana, Nikolaus B. Wagner, Antonio Cozzio, Saskia Kreiter, Angelika Kogler, Markus Streit, Anja Wysocki, Alfred Zippelius, Heinz Läubli, Alexander A. Navarini, and Lara V. Maul. 2022. "Effects of COVID-19 Lockdown on Melanoma Diagnosis in Switzerland: Increased Tumor Thickness in Elderly Females and Shift towards Stage IV Melanoma during Lockdown" Cancers 14, no. 10: 2360. https://doi.org/10.3390/cancers14102360

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