42551 Earlier Detection of Invasive Melanoma After the COVID-19 Pandemic

Background: When detected early, melanoma has a 5-year survival rate of 99%. Therefore, screening is crucial. The American Cancer Society estimated an 80-90% decline in screening for breast, colorectal, and cervical cancers at the onset of the COVID-19 pandemic [1]. We aimed to explore how new melanoma diagnoses were affected by COVID-19. We conducted a retrospective review of all patients with new melanoma diagnoses referred for treatment to surgical offices at an academic institution between 8/2018 and 11/2021. The date 3/15/20 was selected as the COVID-19 cut-off when local dermatology offices temporarily closed. Data were analyzed by t-test and Chi-square analyses. During this period, 382 patients were treated, with 217 patients treated post-COVID. Although patients diagnosed pre- and post-COVID had nonsignificant differences in tumor Breslow depth (p=0.099), patients diagnosed post-COVID were less likely to have ulcerated melanomas (16.1% ulcerated post- COVID vs. 24.8% pre-COVID, p=0.034) and were more likely to have negative lymph node biopsies (87.1% post-COVID vs. 79.3% pre-COVID, p=0.043). Patients diagnosed post-COVID had lower overall stage melanoma (155 stage I post-COVID vs. 99 pre-COVID, p=0.040). Previous studies have shown increases in Breslow depth and stage secondary to the pandemic [2-4]. Our results, covering a long timeframe post-pandemic, support that melanomas are now being detected at earlier stages. This may be due to increased health awareness or greater likelihood to seek treatment for visible concerning lesions. This increase in early melanoma diagnosis after COVID-19 affirms dermatology offices have regained efficiency in the diagnosis and management of melanoma.