Effects of COVID-19 Pandemic on the Diagnosis of Melanoma and Keratinocyte Carcinomas - a Systematic Review and Meta-analysis

Sep 21, 2026

Uploaded by Finn

The COVID-19 pandemic has disrupted healthcare since December 2019, but its true long-term effects on skin cancer diagnosis and outcomes remain unclear. A systematic review and meta-analysis synthesized 27 studies comparing pre- and post-pandemic diagnosis and prognosis, covering 102,263 melanomas and 271,483 keratinocyte carcinomas. Early pandemic months showed marked reductions in surgeries alongside thicker, more advanced tumors, while post-early periods reflected sustained declines and worse ulceration and stage in melanoma and keratinocyte carcinomas. Evidence suggests delays in diagnosis and treatment.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Methods

Design

Data sources and search strategy

Study selection and bias mitigation

Results

Changes in surgeries during early pandemic months

Tumor characteristics by pandemic period

Significance

Implications for diagnosis and treatment strategies

1/12 REVIEW ARTICLE Effects of COVID-19 Pandemic on the Diagnosis of Melanoma and Keratinocyte Carcinomas: a Systematic Review and Meta-analysis Pablo DÍAZ-CALVILLO1,2, Daniel MUÑOZ-BARBA1,2, Clara UREÑA-PANIEGO1,2, Lara Valeska MAUL3, Sara CERMINARA3, Lisa KOSTNER3, Antonio MARTÍNEZ LÓPEZ1,2,* and Salvador ARIAS-SANTIAGO1,2,4 1Department of Dermatology, Virgen de las Nieves University Hospital, 2Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain, 3Department of Dermatology, University Hospital of Basel, Basel, Switzerland, 4Department of Dermatology, University of Granada, Granada, Spain Since December 2019, the COVID-19 pandemic has profoundly affected healthcare. The real effects of the COVID-19 pandemic on skin cancer are still unclear, more than 3 years later. This study aims to summarise the pandemic’s impact on skin cancer diagnosis and outcome. A systematic review and meta-analysis was conducted, selecting studies comparing skin cancer diagnosis and prognosis post-pandemic with pre-pandemic data. A total of 27 papers were reviewed including 102,263 melanomas and 271,483 keratinocyte carcinomas. During the initial pandemic months (January–July 2020), melanoma surgeries dropped by 29.7% and keratinocyte carcinomas surgeries by 50.8%. Early pandemic tumours exhibited greater thickness and stage. In a long-term period beyond the initial months, melanoma surgeries decreased by 9.3%, keratinocyte carcinomas by 16.6%. No significant differences were observed in the Breslow thickness of melanomas after the start of the pandemic (mean difference 0.06, 95% confidence interval –0.46, 0.58). Melanomas operated on post-pandemic onset had an increased risk of ulceration (odds ratio 1.35, 95% confidence interval 1.22–1.50). Keratinocyte carcinomas showed increased thickness and worsened stage post-pandemic. However, studies included were mostly retrospective and cross-sectional, reporting diverse data. This review indicates that the pandemic likely caused delays in skin cancer diagnosis and treatment, potentially impacting patient outcomes. Key words: melanoma; squamous cell carcinoma; basal cell carcinoma; COVID-19 . Submitted Sep 18, 2024. Accepted after review Feb 22, 2024 Published Mar 14, 2024. DOI: 10.2340/actadv.v104.19460 Acta Derm Venereol 2024; 104: adv19460 . Corr: Antonio Martínez-López, Avenida de Madrid 15, ES-18014, Gra nada, Spain. E-mail: [antoniomartinezlopez@aol.com](antoniomartinezlopez@aol.com) IncoDreocneamviesrt20yp1e-92, evereSARS-aCcuteoV-r2e)atory syerged inndWromuhane, China. This virus has spread globally and has produced over 770 million COVID-19 cases and 6.9 million deaths worldwide (1) . In the most affected countries, governments imposed general confinements and COVID-19 forced lifestyle changes (2) . These measures also affected healthcare systems, necessitating adaptations to maintain patient care, with a noticeable neglect SIGNIFICANCE The COVID-19 pandemic has disrupted global healthcare since December 2019, with uncertain long-term effects on skin cancer. Our study reviewing 27 research papers andover 373,000 skin cancer cases found that from January to June 2020, melanoma surgeries decreased by 29.7%, and keratinocyte carcinomas surgeries by 50.8% . Tumours operated on during the pandemic’s early months had increased thickness and stage. Even beyond this phase, melanoma surgeries remained down by 9.3%, and keratinocyte carcinomas by 16.6% . The study suggests that the pandemic likely led to delays in skin cancer diagnosis and treatment, potentially affecting patient outcomes. of other diseases like skin cancer (3). Moreover, patients stopped consulting, primarily due to fear of infection (4) . Skin cancers are the most frequent tumours in humans, with an increasing incidence (5) . Delays in diagnosis mean worse tumour stages, causing poorer survival rates and the need for more complex procedures, such as surgical flaps or grafts and adjuvant therapies (

FAQs

What was the goal of the systematic review and meta-analysis?

To summarize how the COVID-19 pandemic affected skin cancer diagnosis and outcomes, comparing post-pandemic data with pre-pandemic data.

How did surgeries for melanoma and keratinocyte carcinomas change during the initial pandemic months?

Between January and July 2020, melanoma surgeries dropped by 29.7% and keratinocyte carcinomas surgeries dropped by 50.8%.

What tumor-related changes were observed after the start of the pandemic?

Early pandemic tumors showed greater thickness and stage. Post-pandemic onset melanomas had an increased risk of ulceration, and keratinocyte carcinomas showed increased thickness and worsened stage.

Sep 21, 2026

Uploaded by Finn