Department of Dermatology, Virgen de las Nieves University Hospital, Granada, Spain; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.
Department of Dermatology, University Hospital of Basel, Basel, Switzerland.
Acta Derm Venereol. 2024 Mar 14;104:adv19460. doi: 10.2340/actadv.v104.19460.
Since December 2019, the COVID-19 pandemic has profoundly affected healthcare. The real effects of the COVID-19 pandemic on skin cancer are still unclear, more than 3 years later. This study aims to summarise the pandemic's impact on skin cancer diagnosis and outcome. A systematic review and meta-analysis was conducted, selecting studies comparing skin cancer diagnosis and prognosis post-pandemic with pre-pandemic data. A total of 27 papers were reviewed including 102,263 melanomas and 271,483 keratinocyte carcinomas. During the initial pandemic months (January-July 2020), melanoma surgeries dropped by 29.7% and keratinocyte carcinomas surgeries by 50.8%. Early pandemic tumours exhibited greater thickness and stage. In a long-term period beyond the initial months, melanoma surgeries decreased by 9.3%, keratinocyte carcinomas by 16.6%. No significant differences were observed in the Breslow thickness of melanomas after the start of the pandemic (mean difference 0.06, 95% confidence interval -0.46, 0.58). Melanomas operated on post-pandemic onset had an increased risk of ulceration (odds ratio 1.35, 95% confidence interval 1.22-1.50). Keratinocyte carcinomas showed increased thickness and worsened stage post-pandemic. However, studies included were mostly retrospective and cross-sectional, reporting diverse data. This review indicates that the pandemic likely caused delays in skin cancer diagnosis and treatment, potentially impacting patient outcomes.
自 2019 年 12 月以来，COVID-19 大流行深刻影响了医疗保健。COVID-19 大流行对皮肤癌的实际影响仍不清楚，至今已超过 3 年。本研究旨在总结大流行对皮肤癌诊断和结局的影响。进行了系统评价和荟萃分析，选择了比较大流行后和大流行前皮肤癌诊断和预后数据的研究。共审查了 27 篇论文，其中包括 102263 例黑色素瘤和 271483 例角化细胞癌。在最初的大流行月份（2020 年 1 月至 7 月），黑色素瘤手术减少了 29.7%，角化细胞癌手术减少了 50.8%。早期大流行的肿瘤厚度和分期更大。在最初几个月之后的长期时间里，黑色素瘤手术减少了 9.3%，角化细胞癌手术减少了 16.6%。大流行开始后，黑色素瘤的 Breslow 厚度没有显著差异（平均差异 0.06，95%置信区间-0.46，0.58）。大流行后接受手术的黑色素瘤发生溃疡的风险增加（优势比 1.35，95%置信区间 1.22-1.50）。角化细胞癌在大流行后厚度增加，分期恶化。然而，所纳入的研究大多为回顾性和横断面研究，报告的数据各不相同。本综述表明，大流行可能导致皮肤癌诊断和治疗的延迟，从而可能影响患者的结局。
