Close up of melanoma
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A new study has shown that delays in diagnosis of melanoma in Europe due to COVID-19 lockdowns may have contributed to the loss of more than 100,000 life-years and costs that exceed £6 billion, mostly related to loss of productivity. The research, published last week in a new JAMA Network Open paper underscores the importance of early diagnosis of disease and these unintended consequences may help inform how to manage future pandemics.

“When lockdowns were introduced as a much-needed measure to stop the spread of Covid-19, there were extensive unintended consequences. Many screenings were canceled and medical treatments were delayed,” said co-lead author Kaustubh Adhikari, PhD, a statistical geneticist with University College London (UCL), which led the study along with University Hospital of Basel researchers. “As many people missed appointments to detect or treat skin cancer, their cancer progressed to a later stage, which resulted in more expensive care and a greater risk that the treatment would not be successful.”

The study included researchers from the U.K., Switzerland, Germany, U.S., Italy, Australia and Hungary who were seeking to understand the health economic consequences of delays of diagnosing melanoma. The researchers used information from more than 50,000 patients from two treatment centers in Switzerland and Italy, with additional supporting data from the U.K. and Belgium.

Using these data, the investigators estimated how many cancers would have progressed from one stage of the disease to the next due to delays in either beginning or continuing treatment for melanoma based on a variety of factors that disrupted diagnosis and treatment during COVID-19. The result showed that in an estimated 17% of melanoma patients, their cancer would have progressed to a higher stage during 2020-2021, due to delays in diagnosis or treatment of two to three months or longer.

From this determination the team then made estimates of how that translated into higher medical costs, since treating later-stage melanoma is more expensive and has a lower success rate. The costs estimates included both direct costs to the healthcare providers as well as the broader impacts of the indirect costs associated with loss of productivity and life-years lost.

In their analysis estimating the effects across 31 European countries, the team determined that delayed diagnoses contributed to 111,464 years of life lost with a total economic impact of more than £6 billion.

“Our findings show that preventative healthcare always needs to be a top priority, both in normal times and in times of crisis; any plans for potential future pandemics need to consider unintended side effects on a wide range of health conditions and plan holistically,” noted co-lead author Elisabeth Roider, MD, PhD, a physician scientist at University Hospital Basel.

Adhikari emphasized that their findings were for just one of the 10 most common cancers in Europe and points to the need to balance health priorities in response to any future pandemics.

“It’s alarming that for just one disease, there were many years of life lost, a lower quality of life for many thousands of people, and billions of pounds of economic impact – this may be just the tip of the iceberg of the consequences of delayed diagnosis and treatment due to lockdowns,” he said.

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