COVID-19 shutdowns caused delays in melanoma diagnoses, study finds

A new study by OHSU researchers shows an increase in potentially advanced stages of melanoma skin cancer after delays in healthcare due to the COVID-19 pandemic. (Getty Images)

The disruptions caused by the COVID-19 pandemic have affected all areas of healthcare. A new study published in the American Academy of Dermatology found that more melanomas in advanced stages and with aggressive features were being diagnosed during the pandemic, suggesting that COVID-19 shutdowns have caused a delay in diagnosis – and a delay in treatment of the dangerous skin cancer .

Sancy Leachman, MD, Ph.D., in a white coat and gray background.

Sancy Leachman, MD, Ph.D., (OHSU)

Sancy Leachman, MD, Ph.D., chair of OHSU’s Department of Dermatology and director of the OHSU Knight Cancer Institute Melanoma Program, is co-leading the study in collaboration with Harvard Medical School and Brigham and Women’s Hospital, and colleagues at 12 academic centers with dedicated melanoma clinics across the country. She says the study results, coupled with declining rates of new melanoma diagnoses nationwide, suggest that melanoma cases went undiagnosed during the COVID-19 pandemic and did not been identified only after the cancer has progressed to later stages.

“As someone dedicated to the treatment and prevention of melanoma, the study results are sobering,” says Leachman. “It appears that some melanoma patients could not be seen as easily due to COVID restrictions, resulting in worse and potentially more fatal cases of melanoma.”

The study observed increased rates of patient-identified melanomas and decreased rates of provider-identified melanomas during the COVID-19 pandemic, and the cancers were at more advanced stages at the time of diagnosis, highlighting the importance of screening people at high risk. Melanoma is the most dangerous type of skin cancer, in part because it’s much more likely to spread to other parts of the body if not detected and treated early.

Leachman says it’s an issue that needs to be considered in future pandemics and balanced with the need to control the virus.

“If you are a high-risk melanoma patient or see anything suspicious – even if it is during a pandemic – it is extremely important that you are seen by a provider, even if it is done virtually or by sending a photo,” she says. “Death is not the outcome we want for anyone, whether it’s COVID or melanoma, so the risks during a pandemic have to be balanced.”

Defer care

Hospitals continue to face high demand and a backlog due to the pandemic. Because delays in care often exacerbate health issues, patients arrive at OHSU with more complex and acute health care needs due to delays in care during the pandemic.

OHSU leaders advise people to stay up to date on preventative health care, like skin cancer screenings; get regular health checks; and don’t ignore health issues.

Elizabeth Berry MD (OHSU) in white coat and brown background.

Elizabeth Berry MD (OHSU)

“Following the COVID-19 closures, our team has seen more people in my clinic with more advanced melanomas, and that’s reflected in the data from this national study,” said Elizabeth Berry, MD, an associate professor of dermatology at the OHSU School of Medicine and co-author of the study. “We also see this trend in other types of skin cancer. Fortunately, people are now seeking care, but it will take time for us to catch up.

“Begin to see the melanoma”

Caleb Freeman, MD, is a second-year resident in the Department of Dermatology who led OHSU data collection for the study. He says delays in melanoma diagnosis due to COVID-19 reinforce the importance of routine skin exams.

“Of the melanoma cases diagnosed in the first year of the pandemic, more than 50% were first detected independently by the patient,” he says. “We encourage everyone to familiarize themselves with melanoma skin findings and to seek further evaluation by a medical professional if there is an issue. Any delay in diagnosis can be costly.

To raise awareness about what people can do to check their skin, the Dermatology team created a public health campaign called “Start Seeing Melanoma”, explaining what to look for, how to do the exams correctly skin and what to do if you find anything suspicious. .

Funding for this study was provided by the Melanoma Research Foundation.