The thickness of the disease increases at the time of diagnosis, a decisive indicator for establishing the course of treatment and the chances of recovery
Delays in melanoma diagnoses due to the pandemic continue to be felt in terms of more advanced and therefore difficult to treat cases of skin cancer. This was revealed by a study conducted at the Melanoma Unit of the Dermopathic Institute of the Immaculate Conception (IDI) in Rome and published in the journal Journal of the European Academy of Dermatology and Venereology
, which confirmed that the severity of melanomas diagnosed by the IDI in the early months of 2021 remained higher than in the pre-pandemic period. Already in 2020, a study, also conducted by the IDI, had observed a significant increase in the severity of new cases of melanoma with a substantial increase in their degree of infiltration (the Breslow thickness) which had gone from a mean of 0.88 mm in the pre-pandemic phase to a mean of 1.96 mm in the immediate post-lockdown.
The thickness of the determining melanoma
The new work shows that the days of the study period (January-June 2021) were 157 and the new cases of melanoma detected 294, with an average number of 1.9 new diagnoses per day (slightly lower than the 2.3 new diagnoses daily observed at the IDI in the pre-pandemic phase). The greater severity of melanomas seen in the immediate post-lockdown of 2020 is also repeated in the first months of 2021. This greater severity was evident both for the mean Breslow thickness (1.4 mm in 2021 versus 0.88 mm in the pre-pandemic period), and for the clinical characteristics of these tumors, with a higher proportion of nodular melanomas. (13.7% versus 4.2%), ulcerated (10.4% versus 5.9%) or with a nodular growth component (10.0% versus 5.0%). The indirect consequences of the pandemic are felt for patients who are diagnosed with more advanced melanoma – he says Paolo Marchettiscientific director IDI of Rome, full professor of Oncology at the University La Sapienza of Rome and president of the Foundation for personalized medicine -. The thickness of the melanoma determining the path of treatment. When less than a millimeter, surgery is enough in most cases to achieve healing. When it exceeds the millimeter, on the other hand, it is necessary to evaluate any involvement of the lymph nodes (sentinel lymph node technique) and a different disease extension balance with second and third level examinations, because the risk of disease recurrence is higher.
More health conscious women
More advanced diagnoses result not only in greater suffering for patients and their families, but also in considerable costs for the national health system. The diagnostic delay accumulated in 2020 was not fully absorbed in 2021 – continues Marchetti -. Interventions by the institutions are therefore necessary, also in terms of investments to hire more medical and nursing staff, with the aim of restoring and accelerating the pathways of diagnosis and treatment of melanoma. The percentage of less severe melanomas remained substantially stable in the various pandemic phases (25-28% of the total melanomas) and very close to the values observed in the period 2018-2019. The diagnostic delay mainly concerned men aged 50 or over. A positive note that emerges from the study is the greater attention paid by women to the body and health in general – concludes the expert -. In fact, the diagnostic delay is lower in women than in men. Hence the importance of targeted awareness campaigns aimed at the male population. In conclusion, our findings suggest that we may still pay the price of reducing preventionthe later diagnoses and the reduced number of early diagnoses caused by the pandemic.
February 24, 2022 (change February 24, 2022 | 18:29)
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