Date of Completion

2021

Document Type

Article

Faculty Advisor/Sponsor

Anne Stowman, MD

Second Advisor

Mark Fung, MD PhD

Keywords

melanoma, covid-19, pandemic, breslow, skin cancer, telemedicine

Abstract

Skin cancer is the most common type of cancer in the United States, with most skin cancer deaths attributed to malignant melanoma. Early detection and recognition of melanoma through full body skin exam screenings and biopsies is critical to identify early-stage melanoma and decrease progression to metastasis. The COVID-19 (SARS-CoV-2) pandemic led to a significant disruption in the volume and format of routine dermatologic outpatient care. In Vermont, the pandemic caused two months of a near hospital-wide shut down at the University of Vermont Medical Center (UVMMC) and a prolonged period of reduced clinic appointments beginning in March 2020. Telemedicine was used as an alternative to in-person clinic appointments, which may have complicated the ability to assess pre-malignant and malignant lesions. Delayed diagnosis of melanoma carries a significant burden to patients in terms of morbidity and mortality risk, along with healthcare costs of treating invasive or metastatic melanoma. With a sample size of 190 specimens from January-June 2019-2021, analysis showed that diagnoses of melanoma decreased while mean tumor thickness increased from 2019-2020. However, this was not found to be a statistically significant difference from 2019-2020 or 2020. Therefore, it may be concluded that the UVMMC institutional shutdown due to the COVID-19 did not significantly impact diagnosis and staging of melanoma. This could be due to the triage process for suspected melanoma or the reduced burden of COVID-19 on the state of Vermont in Spring-Summer 2020 when compared nationally. However, a larger sample of specimens across a longer period is warranted to explore the trends noted in this study.

Comments

Thank you to my mentors: Anne Stowman, MD and Mark Fung, MD, PhD

Special thanks: Tim St. John, CT (ASCP)

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