Lockdown diagnosis delays caused jump in skin cancer deaths, study suggests
Delays in diagnosis and treatment of a dangerous type of skin cancer because of Covid lockdowns resulted in more than 100,000 years of life lost across Europe and cost the economy more than £6bn, research has suggested.
While lockdowns saved lives from Covid, ramifications of the restrictions are apparent in many areas of healthcare, from lengthy waiting lists for surgery to delays in cancer diagnoses and treatment.
Researchers studying the impact of lockdowns on people with melanoma say policymakers must do more to encourage prevention of the disease and put in place plans to prevent disruption to screening services in case of future pandemics.
“Lockdowns are definitely necessary and useful in saving lives directly from Covid, but they have contributed to lives lost in an indirect way. And all of these should be thought about when making our pandemic preparedness strategies for the future,” said Dr Kaustubh Adhikari, of University College London and the Open University, who co-authored the study.
Writing in the journal JAMA Network Open, an international team of researchers describe how they used data from about 900 patients in Switzerland and Hungary collected from before 2020 until December 2021, to estimate the proportion of people diagnosed with different stages of melanoma before and during the pandemic.
The results reveal a greater proportion of people were diagnosed with more advanced melanoma during the pandemic in both countries. Overall, the team estimate 17% of patients progressed to a more severe cancer stage as a result of lockdown-associated delays in diagnosis or treatment.
The team used this estimate, together with data on treatment costs for different stages, melanoma incidence rates, duration of lockdowns, and years of healthy life lost for each stage of melanoma – as well as other metrics – from across a host of countries in Europe to assess the impact of lockdowns on melanoma patients.
The results suggest Covid lockdowns, defined by the team as “the elimination of routine medical examinations and severely restricted access to follow-up examinations for at least four weeks”, took their toll on the health of people with melanoma and the economy.
Overall, the researchers suggest such measures contributed to 111,464 years of life lost across 31 countries in Europe, including Germany, France and the UK, with a total economic cost of £6.1bn – largely because of a loss of productivity as a result of death or disability from melanoma.
While the team say the work has limitations – including due to extrapolating the results from two countries to others, as well as diversity in European health care systems and the absence of consideration of mental health impacts – the say it highlights the importance of maintaining screening and prevention during health crises.
Dr Adil Sheraz, consultant dermatologist and the British Skin Foundation spokesperson, who was not involved in the study, said he was not surprised by the results.
“Unfortunately, lockdown during the Covid-19 pandemic meant restricted access to virtually all outpatient-based specialties. There were also, of course, difficulties in seeing GPs face to face. Diagnosing melanomas without seeing lesions in person can be extremely difficult,” he said.
“The findings in this multi-centre study are not surprising, and the loss of productivity and health outcomes reinforces the importance for screening for melanomas.”