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大流行第二年的黑色素瘤检测、治疗、生存率和死亡率。

Melanoma detection, treatment, survival, and mortality through year 2 of the pandemic.

作者信息

Kim Uriel, Hoehn Richard S, Koroukian Siran M, Rose Johnie, Bordeaux Jeremy S, Carroll Bryan T

机构信息

School of Medicine, Case Western Reserve University, Cleveland, OH, 44106, USA.

Department of Population and Quantitative Health Sciences School of Medicine, Case Western Reserve University, Cleveland, OH, 44106, USA.

出版信息

Arch Dermatol Res. 2025 Jan 9;317(1):209. doi: 10.1007/s00403-024-03751-1.

Abstract

The COVID-19 pandemic affected the timely diagnosis and treatment of many cancers, including melanoma, the fifth most common cancer in the U.S. This study aimed to quantify the disruption and recovery of melanoma detection, treatment, survival, and mortality during the pandemic by analyzing data from the Surveillance, Epidemiology, and End Results (SEER) program from 2000 to 2021. Our epidemiological analysis found that melanoma incidence initially dropped by 14.8% (95% CI: - 17.2 to - 12.4) in 2020 compared to pre-pandemic projections. Although incidence rates substantially recovered by 2021, an estimated 10,274 patients (95% CI: - 12,824 to - 7,724) remained undiagnosed due to pandemic-related disruptions. Time-to-treatment and 1-year survival were mostly consistent with pre-pandemic trends, while melanoma-specific mortality modestly declined by 4.5% (95% CI: - 14.6 to 5.6) in 2021, though this was statistically non-significant. These findings suggest that healthcare systems adapted to the challenges posed by the pandemic, maintaining essential cancer services. However, the significant drop in melanoma diagnoses likely contributed to the observed reduction in mortality. Thus, re-establishing care for patients missed during the pandemic will be crucial to preventing a future increase in advanced-stage melanoma and related deaths.

摘要

新冠疫情影响了包括黑色素瘤在内的多种癌症的及时诊断和治疗,黑色素瘤是美国第五大常见癌症。本研究旨在通过分析2000年至2021年监测、流行病学和最终结果(SEER)项目的数据,量化疫情期间黑色素瘤检测、治疗、生存和死亡率的中断及恢复情况。我们的流行病学分析发现,与疫情前的预测相比,2020年黑色素瘤发病率最初下降了14.8%(95%置信区间:-17.2至-12.4)。尽管到2021年发病率大幅回升,但由于疫情相关干扰,估计仍有10274名患者(95%置信区间:-12824至-7724)未被诊断。治疗时间和1年生存率大多与疫情前趋势一致,而2021年黑色素瘤特异性死亡率适度下降了4.5%(95%置信区间:-14.6至5.6),不过这在统计学上无显著意义。这些发现表明,医疗系统适应了疫情带来的挑战,维持了基本的癌症服务。然而,黑色素瘤诊断的显著下降可能导致了观察到的死亡率降低。因此,重新为疫情期间错过治疗的患者提供护理对于防止未来晚期黑色素瘤及相关死亡人数增加至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8414/11717807/e1c5827d7360/403_2024_3751_Fig1_HTML.jpg

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