1. The Effect of the COVID-19 Lockdown on Melanoma Diagnosis in Italy
- Author
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Giuseppe Micali, Fabrizio Fantini, Piergiacomo Calzavara-Pinton, Francesco Lacarruba, Giuseppe Amoruso, Pietro Quaglino, Martina Merli, Mario Puviani, Giulio Gualdi, Marta Di Nicola, Gabriella Fabroncini, Massimiliano Scalvenzi, Gaetano Giannotta, Paolo Amerio, Pietro Di Marino, Maria Concetta Fargnoli, Marco Rubatto, Michele De Tursi, Andrea Di Buduo, Annamaria Porreca, Franco Rongioletti, Paolo Sbano, Laura Atzori, Alessia Villani, Andrea Lotesoriere, Simone Soglia, Andrea Paradisi, Laura Sollima, Gualdi, G., Porreca, A., Amoruso, G. F., Atzori, L., Calzavara-Pinton, P., De Tursi, M., Buduo, A. D., Marino, P. D., Fabroncini, G., Fantini, F., Fargnoli, M. C., Giannotta, G., Lacarruba, F., Lotesoriere, A., Merli, M., Micali, G., Paradisi, A., Puviani, M., Quaglino, P., Rongioletti, F., Rubatto, M., Sbano, P., Scalvenzi, M., Soglia, S., Sollima, L., Villani, A., Nicola, M. D., and Amerio, P.
- Subjects
Oncology ,medicine.medical_specialty ,Skin Neoplasms ,Mitotic index ,Coronavirus disease 2019 (COVID-19) ,Dermatology ,Prognostic factors ,Breslow Thickness ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Retrospective Studie ,Internal medicine ,Vertical growth ,Humans ,Medicine ,Melanoma ,Survival rate ,Melanoma diagnosis ,Retrospective Studies ,030203 arthritis & rheumatology ,SARS-CoV-2 ,business.industry ,COVID-19 ,medicine.disease ,Communicable Disease Control ,Italy ,Mitoses ,Breslow ,COVID-19: Important Updates and Developments ,business ,Human ,Cohort study - Abstract
The coronavirus disease 2019 (COVID-19) pandemic has led to lockdowns for much of the world. In Italy, all health procedures not directly related to COVID-19 were reduced or suspended, thus limiting patient access to hospitals. Any delay in cancer treatment presents the additional risk of tumors progressing from being curable to incurable. Specifically, melanoma survival rate strictly depends on tumor thickness, which, in turn, is a function of time. To estimate the impact on melanoma progression caused by the reduction in dermatologic services during the COVID-19 lockdown, a retrospective observational cohort study was conducted. This study was designed to compare the clinical and histologic characteristics of the primary melanomas removed in the first 2 months after the end of the lockdown (May-July 2020) in 12 Italian centers characterized by different COVID-19 case frequencies. The control group was represented by the melanomas removed during the same period in the previous 3 years. Overall, 1,124 melanomas were considered: 237 as part of the study group and 887 from the control group (average, 295), with a 20% reduction. Breslow thickness, as well as high-risk histotypes and melanomas with vertical growth, increased for all melanomas. Ulcerated and high mitotic index melanomas increased, particularly in northern Italy. In Italy, the lockdown led to a significant worsening of melanoma severity, causing a staging jump, with a consequent worsening of outcomes.
- Published
- 2021