Impact of the Covid-19 pandemic on melanoma and non-melanoma skin cancer inpatient treatment in Germany - a nationwide analysis

J Eur Acad Dermatol Venereol. 2022 Oct;36(10):1766-1773. doi: 10.1111/jdv.18217. Epub 2022 Jun 17.

Abstract

Background: SARS-CoV-2 has massively changed the care situation in hospitals worldwide. Although tumour care should not be affected, initial reports from European countries were suggestive for a decrease in skin cancer during the first pandemic wave and only limited data are available thereafter.

Objectives: The aim of this study was to investigate skin cancer cases and surgeries in a nationwide inpatient dataset in Germany.

Methods: Comparative analyses were performed in a prepandemic (18 March 2019 until 17 March 2020) and a pandemic cohort (18 March 2020 until 17 March 2021). Cases were identified and analysed using the WHO international classification of diseases codes (ICDs) and process key codes (OPSs).

Results: Comparing the first year of the pandemic with the same period 1 year before, a persistent decrease of 14% in skin cancer cases (n = 19 063) was observed. The largest decrease of 24% was seen in non-invasive in situ tumours (n = 1665), followed by non-melanoma skin cancer (NMSC) with a decrease of 16% (n = 15 310) and malignant melanoma (MM) with a reduction of 7% (n = 2088). Subgroup analysis showed significant differences in the distribution of sex, age, hospital carrier type and hospital volume. There was a decrease of 17% in surgical procedures (n = 22 548), which was more pronounced in minor surgical procedures with a decrease of 24.6% compared to extended skin surgery including micrographic surgery with a decrease of 15.9%.

Conclusions: Hospital admissions and surgical procedures decreased persistently since the beginning of the pandemic in Germany for skin cancer patients. The higher decrease in NMSC cases compared to MM might reflect a prioritization effect. Further evidence from tumour registries is needed to investigate the consequences of the therapy delay and identify the upcoming challenges in skin cancer care.

MeSH terms

  • COVID-19* / epidemiology
  • Cutaneous Malignant Melanoma
  • Germany / epidemiology
  • Humans
  • Inpatients
  • Melanoma* / epidemiology
  • Melanoma* / pathology
  • Melanoma* / therapy
  • Pandemics
  • SARS-CoV-2
  • Skin Neoplasms* / epidemiology
  • Skin Neoplasms* / therapy