Effects of COVID-19 Lockdown on Tumour Burden of Melanoma and Cutaneous Squamous Cell Carcinoma
Antonio Tejera-Vaquerizo, Sabela Paradela, Agusti Toll, Jorge Santos-Juanes, Ane Jaka, Alba López, Javier Cañueto, Àlvaro Bernal, Isabel Villegas-Romero, Carla Ferrándiz-Pulido, Héctor Perandones, David Moreno-Ramírez, Carolina Domínguez-Mahamud, Rafael Salido-Vallejo, Onofre Sanmartin, Francisco M. Almazán-Fernández, Pedro Rodríguez-Jiménez, José Bañuls, Sebastian Podlipnik, Alejandra Sandoval-Clavijo, Aram Boada, Beatriz García-Bracamonte, Sara Palencia, David Revilla-Nevreda, Enara Reola-Ramírez, María del Carmen Gómez-Mateo, Mario Linares-Barrios, David Jiménez-Gallo, Carlos González-Cruz, Elia Samaniego, María Navedo-de las Heras, Rosa Taberner, Teresa Ródenas-Herranz, Carmen García-Donoso, Susana Puig, Eduardo Nagore
The aim of this study was to compare tumour burden in patients who underwent surgery for melanoma and cutaneous squamous cell carcinoma during nationwide lockdown in Spain due to COVID-19 (for the period 14 March to 13 June 2020) and during the same dates in 2019 before the COVID-19 pandemic. In addition, associations between median tumour burden (Breslow thickness for melanoma and maximum clinical diameter for cutaneous squamous cell carcinoma) and demographic, clinical, and medical factors were analysed, building a multivariate linear regression model. During the 3 months of lockdown, there was a significant decrease in skin tumours operated on (41% decrease for melanoma (n = 352 vs n = 207) and 44% decrease for cutaneous squamous cell carcinoma (n = 770 vs n = 429)) compared with the previous year. The proportion of large skin tumours operated on increased. Fear of SARS-CoV-2 infection, with respect to family member/close contact, and detection of the lesion by the patient or doctor, were related to thicker melanomas; and fear of being diagnosed with cancer, and detection of the lesion by the patient or relatives, were related to larger size cutaneous squamous cell carcinoma. In conclusion, lockdown due to COVID-19 has resulted in a reduction in treatment of skin cancer.
There is little evidence regarding the impact of COVID-19 lockdown on skin tumour burden. The COVID-19 lockdown resulted in a reduction in surgery for melanoma and cutaneous squamous cell carcinoma and an increase in the proportion of tumours with a worse prognosis. The increase was due to patient-dependent factors; in particular, fear of SARS-CoV-2 infection. Therefore, health education programmes targeting the general population are needed to ensure the prompt treatment of patients with skin cancer.