| Autor: |
Kostner L; Department of Dermatology, University Hospital of Basel, 4031 Basel, Switzerland., Cerminara SE; Department of Dermatology, University Hospital of Basel, 4031 Basel, Switzerland., Pamplona GSP; Department of Ophthalmology, University of Lausanne, 1004 Lausanne, Switzerland.; Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland., Maul JT; Department of Dermatology, University Hospital of Zurich, 8091 Zurich, Switzerland., Dummer R; Department of Dermatology, University Hospital of Zurich, 8091 Zurich, Switzerland., Ramelyte E; Department of Dermatology, University Hospital of Zurich, 8091 Zurich, Switzerland., Mangana J; Department of Dermatology, University Hospital of Zurich, 8091 Zurich, Switzerland., Wagner NB; Department of Dermatology, Cantonal Hospital of St. Gallen, 9000 St. Gallen, Switzerland., Cozzio A; Department of Dermatology, Cantonal Hospital of St. Gallen, 9000 St. Gallen, Switzerland., Kreiter S; Department of Dermatology, Cantonal Hospital of St. Gallen, 9000 St. Gallen, Switzerland., Kogler A; Department of Dermatology, Cantonal Hospital of St. Gallen, 9000 St. Gallen, Switzerland., Streit M; Department of Dermatology, Cantonal Hospital of Aarau, 5001 Aarau, Switzerland., Wysocki A; Department of Dermatology, Cantonal Hospital of Lucerne, 6000 Lucerne, Switzerland., Zippelius A; Department of Theragnostics, Division of Oncology, University Hospital Basel, 4031 Basel, Switzerland.; Laboratory of Cancer Immunology and Immunotherapy, Department of Biomedicine, University of Basel, University Hospital of Basel, 4031 Basel, Switzerland., Läubli H; Department of Theragnostics, Division of Oncology, University Hospital Basel, 4031 Basel, Switzerland.; Laboratory of Cancer Immunology and Immunotherapy, Department of Biomedicine, University of Basel, University Hospital of Basel, 4031 Basel, Switzerland., Navarini AA; Department of Dermatology, University Hospital of Basel, 4031 Basel, Switzerland., Maul LV; Department of Dermatology, University Hospital of Basel, 4031 Basel, Switzerland. |
| Abstrakt: |
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. |
