Response to Trepanowski et al’s “Delays in melanoma presentation during the COVID-19 pandemic: a nationwide multi-institutional cohort study”

The COVID-19 pandemic has impacted skin cancer care globally, resulting in delayed diagnoses and potentially causing progression to more advanced tumor stages.1Shannon A.B. Sharon C.E. Straker III, R.J. et al.The impact of the COVID-19 pandemic on the presentation status of newly diagnosed melanoma: a single institution experience.J Am Acad Dermatol. 2021; 84: 1096-1098Abstract Full Text Full Text PDF PubMed Scopus (28) Google Scholar We read with great interest the article by Trepanowski et al2Trepanowski N. Chang M.S. Zhou G. et al.Delays in melanoma presentation during the COVID-19 pandemic: a nationwide multi-institutional cohort study.J Am Acad Dermatol. 2022; 87: 1217-1219Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar evaluating the impact of the pandemic on melanoma presentation. The authors reported a significant proportion of melanomas with aggressive features at diagnosis during the COVID-19 pandemic.2Trepanowski N. Chang M.S. Zhou G. et al.Delays in melanoma presentation during the COVID-19 pandemic: a nationwide multi-institutional cohort study.J Am Acad Dermatol. 2022; 87: 1217-1219Abstract Full Text Full Text PDF PubMed Scopus (11) Google Scholar We wish to add our experience of the effect of the pandemic on melanoma presentation, and additionally, to assess the ongoing impact in the postpandemic era. In 2020, Ireland was under lockdown from March to June, August to November, and again in December. January 2021 marked the beginning of the post-COVID-19 era. Restrictions were eased gradually without the return of strict lockdown periods due to the recovery of regular hospital services, including rapid-access cancer clinics, and the wide availability and uptake of COVID-19 vaccinations.3Crowley P. Hughes A. The impact of COVID-19 pandemic and the societal restrictions on the health and wellbeing of the population, and on the health service capacity and delivery: a plan for healthcare and population health recovery. version 2; May 2021. National QI Team, Health Service Executive.https://www.hse.ie/eng/about/who/qid/covid-19-qi-learning/qi-resources-to-support-learning-from-covid19/covid-19-pandemic-impact-paper-2021.pdfDate accessed: July 27, 2023Google Scholar This retrospective study included new melanoma diagnoses, discussed at our multi-center multidisciplinary team meeting from 2019 to 2021. Melanoma cases were categorized as pre-COVID-19 (2019), COVID-19 (2020), and post-COVID-19 (2021). Tumor characteristics and histopathologic American Joint Committee on Cancer-8 (AJCC-8) staging features were compared across all time periods. Methods of statistical analysis and results are outlined in Table I.Table ITumor characteristics for melanomas diagnosed between 2019 and 20212019 n (%)2020 n (%)2021 n (%)P value†Categorical variables were compared using Fisher exact test. Continuous variables were compared using Kruskal–Wallis test. Unknown values were excluded from analysis.,‡P values were adjusted for multiple comparisons using the Benjamini–Hochberg method. Bold values indicate statistically significant results, defined as P50%). Full-Text PDF