Impact of the Covid?19 pandemic on Melanoma and Non?melanoma skin cancer inpatient treatment in Germany ? a nationwide analysis

AbstractBackground

SARS-CoV-2 has massively changed the care situation in hospitals worldwide. Although tumor care should not be affected, initial reports from European countries were suggestive for a decrease in skin cancer during the first pandemic wave and only limited data is available thereafter.

Objectives

The aim of this study was to investigate skin cancer cases and surgeries in a nationwide inpatient dataset in Germany.

Methods

Comparative analyses were performed in a pre-pandemic (18th March 2019 until 17th March 2020) and a pandemic cohort (18th March 2020 until 17th March 2021). Cases were identified and analyzed using the WHO international classification of diseases codes (ICDs) and process key codes (OPSs).

Results

Comparing the first year of the pandemic with the same period one year before, a persistent decrease of 14% in skin cancer cases (n=19.063) was observed. The largest decrease of 24% was seen in non-invasive in situ tumors (n=1.665), followed by non-melanoma skin cancer (NMSC) with a decrease of 16% (n=15.310) and malignant melanoma (MM) with a reduction of 7% (n=2.088). Subgroup analysis showed significant differences in the distribution of sex, age, hospital carrier type and hospital volume. There was a decrease of 17% in surgical procedures (n=22.548), which was more pronounced in minor surgical procedures with a decrease of 24.6% compared to extended skin surgery including micrographic surgery with a decrease of 15.9%.

Conclusions

Hospital admissions and surgical procedures decreased persistently since the beginning of the pandemic in Germany for skin cancer patients. The higher decrease in NMSC cases compared to MM might reflect a prioritization effect. Further evidence from tumor registries is needed to investigate the consequences of the therapy delay and identify the upcoming challenges in skin cancer care.