THE COVID-19 pandemic disrupted cancer care globally, and new research highlights its measurable impact on melanoma diagnosis and prognostic features across regions with differing public health strategies.
Comparing Sweden and Australia’s COVID-19 Strategies
In this population-based study, researchers analysed invasive cutaneous melanoma cases diagnosed between 2013 and 2021 using registry data from Sweden and Victoria, Australia. These regions were selected due to their contrasting approaches to pandemic control, with Sweden adopting relatively lenient measures and Victoria implementing strict lockdowns. The authors examined changes in melanoma incidence and key prognostic indicators, including Breslow thickness, ulceration, and lymph node involvement, comparing pre-pandemic and pandemic periods.
The findings reveal a clear pandemic-related disruption in melanoma detection. Both regions experienced an immediate decline in melanoma incidence following the onset of COVID-19 in March 2020. This reduction was largely driven by a drop in diagnoses of thin melanomas and was most pronounced among older individuals.
However, regional differences emerged over time. In Victoria, melanoma incidence remained persistently lower throughout the pandemic period, with no recovery to pre-COVID trends. In contrast, Sweden saw a gradual return to expected incidence levels after the initial decline.
Changes in tumour characteristics were modest but notable. In Victoria, although the median Breslow thickness remained stable at 0.7 mm, the distribution shifted significantly, indicating a relative increase in thicker melanomas. Sweden did not show significant changes in tumour thickness overall, but a slight increase in ulceration rates was observed. Importantly, lymph node metastasis rates remained stable in both regions.
Long-Term Consequences for Melanoma Outcomes
The authors suggest that reduced access to healthcare services and delayed presentations during the pandemic likely contributed to fewer diagnoses, particularly of early-stage melanomas. The more sustained impact observed in Victoria may reflect the longer duration and greater intensity of public health restrictions.
Overall, the study underscores the indirect consequences of pandemic control measures on cancer detection. While the reductions in melanoma incidence may partly represent delayed diagnoses rather than true decreases, the shift towards less favourable prognostic features raises concerns about potential long-term outcomes. Continued monitoring and targeted public health strategies will be essential to address any lasting effects on melanoma care.
Reference
Sand C et al. Evaluating COVID-19 Pandemic Impact on Melanoma Incidence and factors in Regions with Different Infection Control Strategies. Br J Dermatol. 2026;DOI: 10.1093/bjd/ljag172.
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