The impact of treatment delay on skin cancer in COVID-19 era: a case-control study

World J Surg Oncol. 2021 Dec 24;19(1):350. doi: 10.1186/s12957-021-02468-z.

Abstract

Background: The outbreak of COVID-19 pandemic led to a 2-month lockdown in Europe. Elective surgeries, including skin cancer excisions, were postponed. The purpose of this prospective case-control study was to assess the impact of the treatment delay on patients with non-melanoma skin cancer (NMSC) or melanoma operated in the first post-lockdown period.

Methods: A comparative study of skin cancer operations performed in a 4-month period either in 2020 or in 2019 was conducted. All data were collected from a prospectively maintained clinic database and the pathological reports. Continuous variables were compared with t test or Mann-Whitney U test according to their distribution. Categorical variables were compared with Fisher exact test. Odds ratio (OR) with 95% confidence interval (95% CI) was used to assess the risk of excising high-risk NMSC in 2020 compared with 2019.

Results: Skin cancer excision was performed in 158 cases in 2020 compared to 125 cases in 2019 (26.4% increase). Significantly, more SCC were excised in 2020 (p = 0.024). No significant difference for several clinical parameters regarding BCC, SCC, and melanoma was identified. However, the reconstructive method applied, following NMSC excision, was significantly different, requiring frequently either skin grafting or a flap.

Conclusion: These results indicate that skin cancer treatment delay, due to COVID-19 pandemic, is related to an increased incidence of SCC and more complicated methods of reconstruction. Considering the relapsing COVID-19 waves, significant skin cancer treatment delays should be avoided.

Trial registration: The study adhered to the STROBE statement for case-control studies.

Keywords: COVID-19; Melanoma; Skin cancer; Squamous cell carcinoma.

MeSH terms

  • COVID-19*
  • Carcinoma, Basal Cell* / epidemiology
  • Carcinoma, Basal Cell* / surgery
  • Case-Control Studies
  • Communicable Disease Control
  • Humans
  • Neoplasm Recurrence, Local
  • Pandemics
  • SARS-CoV-2
  • Skin Neoplasms* / epidemiology
  • Skin Neoplasms* / surgery
  • Time-to-Treatment