Pandemic-Era Delays Led to More Advanced Melanoma Cases, Study Finds
New research reveals significant disruptions to melanoma diagnosis and treatment during the COVID-19 pandemic, resulting in patients presenting with more aggressive disease and a concerning rise in advanced-stage diagnoses. A systematic review, published in JEADV Clinical Practice in 2025, confirms widespread delays in care, mirroring trends observed in other cancer types.
The study, authored by Soni, Purcell, Lim, Marcaccini, Seth, and Rozen, analyzed 53 studies to assess the impact of the pandemic on melanoma patient characteristics. Researchers found a dramatic decrease in referrals and biopsies across multiple countries.Monthly referrals in australia declined by 48%, while Canada experienced a 27% drop in biopsy rates.In Italy, initial visits to dermatologists decreased by as much as 37%, and sentinel lymph node biopsies fell by 29%.
These reductions in diagnostic procedures correlated with a worrying trend: patients were presenting with more advanced melanoma.Breslow thickness - a key measure of melanoma severity – increased in some areas from a pre-pandemic average of 1.1 mm to 1.8 mm during the pandemic. Ulceration rates, indicating a more aggressive form of the disease, nearly doubled in some findings, rising from approximately 11.7% to 22.6%.
The study also noted a decrease in surgical excisions, up to 20% in some regions, likely due to limited resources, reduced hospital capacity, and patient hesitancy. Consequently,more patients were diagnosed with inoperable tumors. These findings align with documented disruptions in care for other cancers, including breast, colorectal, prostate, and cervical cancers, as highlighted in research published in J Gen Intern Med in 2021 by McBain et al.
The authors emphasize the need for proactive planning to mitigate similar disruptions during future global emergencies.They recommend that clinics establish clear policies and frameworks for cancer care, notably for high-risk individuals, including robust dialog and follow-up protocols.
Furthermore, the study advocates for the early adoption of innovative diagnostic tools like teledermatology and artificial intelligence. While not a replacement for in-person care, these technologies can serve as valuable initial screening methods during public health crises. Increased public education regarding self-skin checks and preventative practices is also crucial for promoting earlier intervention.
The research underscores the critical importance of maintaining cancer care access even during times of widespread disruption, to prevent stage migration and improve patient outcomes. As Schadendorf et al. detailed in The lancet in 2018, early detection remains paramount in effectively treating melanoma.
References:
- Soni, A., Purcell, E., Lim, B., Marcaccini, G., Seth, I. and Rozen, W.M. (2025), The Silent Spread: A Systematic Review of Delayed Melanoma Diagnosis and Disease Progression During the COVID-19 Pandemic. JEADV Clinical Practice. https://doi.org/10.1002/jvc2.70154
- McBain RK, Cantor JH, Jena AB, Pera MF, Bravata DM, Whaley CM. Decline and Rebound in Routine Cancer Screening Rates during the COVID-19 Pandemic. J Gen Intern Med. 2021;36(6):1829-1831. doi:10.1007/s11606-021-06660-5
- Schadendorf D, van Akkooi ACJ, Berking C, et al. Melanoma. Lancet.2018;392(10151):971-984. doi:10.1016/S0140-6736(18)31559-9