Dramatic Drop in Skin Cancer Referrals During COVID-19 Crisis

Dawn O'Shea

June 09, 2020

The Dermatology Centre at Salford Royal Trust has reported a dramatic drop in urgent skin cancer referrals since the COVID-19 crisis began.

Writing in the  British Journal of Dermatology , a team from the centre says there was a 34 per cent reduction in referrals in February-April 2020, compared with the same period last year. The largest increase was in April when the centre received 355 referrals under the rapid access two-week wait pathway (TWW), 56.4 per cent lower than in April 2019.

Furthermore, the number of skin cancers diagnosed through the TWW pathway decreased. In March 2020, the number of skin cancers diagnoses was 28, almost half as many as in March 2019 (n=52). Using an average conversion rate (percentage of TWW referrals with a histological diagnosis of skin cancer) over the last five years (6.95%), and based on the average increase in referrals, the centre expected to diagnose 125 malignant melanoma and squamous cell carcinoma in March 2020 and April 2020. Assuming the conversion rate remains stable, the authors predict that this number will drop to 59, a reduction of 53 per cent.

“During the post-COVID pandemic recovery phase there may be a significant rebound wave of TWW skin cancer referrals to dermatology departments across the country. This may further test already stretched resources. Predicting this peak will enable advance planning of the provision of appropriate clinic capacity and associated levels of staffing,” the authors state.

They say: “These findings are a wake-up call to prepare for an upswing in skin cancer referrals later this year. The findings also suggest this trend in referrals may lead to delayed diagnosis, with poorer prognosis, of a wide range of cancer."

Earnshaw CH, Hunter HJA, McMullen E, Griffiths CEM, Warren RB. Reduction in skin cancer diagnosis, and overall cancer referrals, during the COVID-19 pandemic. Br J Dermatol. 2020 Jun 4 [Epub ahead of print]. doi: 10.1111/bjd.19267. PMID: 32500571 View full text.

This article originally appeared on Univadis, part of the Medscape Professional Network.

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