Reduction in skin cancer diagnosis, and overall cancer referrals, during the COVID‐19 pandemic

Earnshaw, Charles H.; Hunter, Hamish J.A.; McMullen, Emma; Griffiths, C. E. M.; Warren, Richard B

doi:10.1111/bjd.19267

Cited by 65 publications

(93 citation statements)

References 2 publications

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“…For malignant cancers, a backlog of patients with potential symptoms in the UK is expected following the COVID-19 emergency. 25 Furthermore, a 34·3% reduction in the number of urgent referrals for diagnosis in the UK was reported between February and April, 2020, 7 with Lai and colleagues reporting a reduction of 70–89% for the same time period. 8 We observed a modest, non-significant, reduction (16·0%) in the number of malignant cancer diagnoses between March 1 and May 31, 2020.…”

Section: Discussionmentioning

confidence: 99%

“…In a report from the Salford Royal NHS Foundation Trust, a reduction of 53% in skin cancer diagnoses was predicted between March and April, 2020. 7 There is a delay between the time when a patient receives a cancer diagnosis in secondary care, and the data being entered into their primary care record. 26 Therefore, the lower reduction in cancer diagnoses observed compared with the other diseases assessed could be partially explained by this time lag.…”

Section: Discussionmentioning

confidence: 99%

“…Emergency department attendance declined by 25% in the week after lockdown was implemented, 3 and data from the Royal College of General Practitioners surveillance system 4 has shown that weekly reported incidence of asthma, intestinal infectious diseases, upper respiratory tract infections, and acute respiratory tract infections was markedly reduced. Substantial reductions in hospital admissions for suspected heart attacks 5 and strokes, 6 and urgent general practitioner (GP) referrals for cancer 7 , 8 have also been reported.…”

Section: Introductionmentioning

confidence: 99%

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Diagnosis of physical and mental health conditions in primary care during the COVID-19 pandemic: a retrospective cohort study

Williams

Jenkins

Ashcroft

et al. 2020

The Lancet Public Health

211

213

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Background To date, research on the indirect impact of the COVID-19 pandemic on the health of the population and the health-care system is scarce. We aimed to investigate the indirect effect of the COVID-19 pandemic on general practice health-care usage, and the subsequent diagnoses of common physical and mental health conditions in a deprived UK population. Methods We did a retrospective cohort study using routinely collected primary care data that was recorded in the Salford Integrated Record between Jan 1, 2010, and May 31, 2020. We extracted the weekly number of clinical codes entered into patient records overall, and for six high-level categories: symptoms and observations, diagnoses, prescriptions, operations and procedures, laboratory tests, and other diagnostic procedures. Negative binomial regression models were applied to monthly counts of first diagnoses of common conditions (common mental health problems, cardiovascular and cerebrovascular disease, type 2 diabetes, and cancer), and corresponding first prescriptions of medications indicative of these conditions. We used these models to predict the expected numbers of first diagnoses and first prescriptions between March 1 and May 31, 2020, which were then compared with the observed numbers for the same time period. Findings Between March 1 and May 31, 2020, 1073 first diagnoses of common mental health problems were reported compared with 2147 expected cases (95% CI 1821 to 2489) based on preceding years, representing a 50·0% reduction (95% CI 41·1 to 56·9). Compared with expected numbers, 456 fewer diagnoses of circulatory system diseases (43·3% reduction, 95% CI 29·6 to 53·5), and 135 fewer type 2 diabetes diagnoses (49·0% reduction, 23·8 to 63·1) were observed. The number of first prescriptions of associated medications was also lower than expected for the same time period. However, the gap between observed and expected cancer diagnoses (31 fewer; 16·0% reduction, −18·1 to 36·6) during this time period was not statistically significant. Interpretation In this deprived urban population, diagnoses of common conditions decreased substantially between March and May 2020, suggesting a large number of patients have undiagnosed conditions. A rebound in future workload could be imminent as COVID-19 restrictions ease and patients with undiagnosed conditions or delayed diagnosis present to primary and secondary health-care services. Such services should prioritise the diagnosis and treatment of these patients to mitigate potential indirect harms to protect public health. Funding National Institute of Health Research.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Diagnosis of physical and mental health conditions in primary care during the COVID-19 pandemic: a retrospective cohort study

Williams

Jenkins

Ashcroft

et al. 2020

The Lancet Public Health

211

213

View full text Add to dashboard Cite

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“…Access to healthcare generally declined in all but the most urgent circumstances, and departments have already identified a reduction in referrals and diagnoses of skin malignancies. 1 …”

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confidence: 99%

Characterising non-melanoma skin cancer undergoing surgical management during the COVID-19 pandemic

Capitelli-McMahon

Hurley

Pinder

et al. 2021

Journal of Plastic, Reconstructive & Aesthetic Surgery

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“…Delay in referral of urgent skin cancers may result in patients presenting later with significantly advanced disease, requiring more extensive surgery and receiving worse outcomes overall. 4 During the COVID-19 pandemic, our plastic surgery service has received 27% (95% CI [16%,36%]) less than predicted urgent skin cancer referrals for the first 5 months of 2020. We expect a surge in the number of referred skin cancers as we enter a post-COVID recovery phase, in addition to a forecasted 12% increase for 2020/21.…”

mentioning

confidence: 99%

Major fall in urgent skin cancer referrals during the COVID-19 outbreak

Rich

O’Neill

2021

Journal of Plastic, Reconstructive & Aesthetic Surgery

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The SARS-CoV-2 cornovirus disease (COVID-19) pandemic has significantly affected referrals of new suspected cancers from primary care to specialist services in the National Health Service (NHS) across the UK. Amongst the many factors causing delay, such as fear and uncertainty about COVID-19 transmission, reluctance to seek medical attention for cancer sypmtoms and avoiding additional pressure on NHS services, we anticipate a surge in urgent skin cancer referrals to our plastic surgery service as we enter a post-COVID recovery phase. On the basis of previous referral data and statistical forecasting, we share our predicted numbers against our actual number of urgent skin cancer referrals for the COVID-19 period and, based on this analysis, encourage all cancer services to prepare and allocate resources appropriately for the busy months to follow.

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Reduction in skin cancer diagnosis, and overall cancer referrals, during the COVID‐19 pandemic

Cited by 65 publications

References 2 publications

Diagnosis of physical and mental health conditions in primary care during the COVID-19 pandemic: a retrospective cohort study

Diagnosis of physical and mental health conditions in primary care during the COVID-19 pandemic: a retrospective cohort study

Characterising non-melanoma skin cancer undergoing surgical management during the COVID-19 pandemic

Major fall in urgent skin cancer referrals during the COVID-19 outbreak

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