COVID-19 Precautions Associated With Delays In Treating Skin Cancer
COVID-19 Precautions Associated With Delays In Treating Skin Cancer

COVID-19 Precautions Associated With Delays In Treating Skin Cancer

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Results from a nationwide study showed that the COVID-19 pandemic significantly affected Mohs micrographic operations and treatment of skin cancer, according to a leader published in Journal of Drugs in Dermatology.

“Initial uncertainty during the COVID-19 pandemic led most medical organizations to recommend postponing all unnecessary visits,” Edward W. Seger, MD, MS, from the University of Kansas Medical Center, and colleagues wrote. “Unfortunately, for patients with newly diagnosed skin cancer, many Mohs surgeries were included in this delay.”

To assess the impact of the pandemic on Mohs micrographic surgery (MMS) and treatment of skin cancer, Seger and colleagues developed a study with 15 questions approved by the institution. The study was sent electronically to scholarship-trained Mohs surgeons who practiced 6 months after the onset of the pandemic.

Of the 303 respondents, 81% were private practitioners and 57% worked in suburbs. In addition, 82% noted a decrease in case volume for at least 3 months, and 68.5% noticed an increase in case difficulty after processing delays.

Respondents reported that adverse outcomes were common, including 69% who reported cases of local tumor spread, 49% who reported cases of progression of the tumor stage and 20% who reported cases of regional or systemic metastases.

Other details from the study included an observation of general damage from delays (78%) and deteriorating emotional health (76%).

While 45% of surgeons agreed with practice restrictions at the onset of the pandemic, only 29% maintained that position at present. Overall, 39% of respondents had a “less favorable view of recommendations now than they had originally” compared to 4% who reported a more favorable view.

However, cases of COVID-19 were rare, with eight respondents reporting positive tests from staff and seven respondents reporting positive testicles from patients following MMS procedures.

Overall, 97% of respondents felt that they could take reasonable precautions to prevent the spread of COVID-19 and were comfortable performing MMS operations.

“While skin cancer surgery is not typically considered ’emergency treatment,’ these current findings show that delays in care can lead to increases in local tumor spread and upgrading of skin cancer,” Seger and colleagues wrote. “By combining the risk of delaying treatment with a rare spread among patients and staff, it is obvious that surgeries should continue and can be performed safely.”

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