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The impact of the COVID-19 pandemic on keratinocyte carcinoma in the Netherlands : trends in diagnoses and magnitude of diagnostic delays

Slotman, E. (2021) The impact of the COVID-19 pandemic on keratinocyte carcinoma in the Netherlands : trends in diagnoses and magnitude of diagnostic delays.

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Abstract:Background The COVID-19 pandemic and associated measures considerably impacted the Dutch society and healthcare system. Focus switched to care for patients with COVID-19 and patients were reluctant to visit healthcare services. This study aimed to investigate the impact of the COVID-19 pandemic on the trends in diagnoses of keratinocyte carcinoma (cutaneous squamous cell carcinoma (cSCC), basal cell carcinoma (BCC)) and to assess the magnitude of diagnostic delays. Materials and methods The number of cSCC and BCC diagnoses in each month of 2020 was compared to the expected number of diagnoses for these months, using data from the Netherlands Cancer Registry. Comparisons were further stratified by age, sex, and region. Expected diagnoses for 2020 were used as a reference to take the yearly increasing trend in keratinocyte carcinoma incidence into account and were calculated by extrapolating the trends observed in 2017-2019. Estimates of diagnostic delays were calculated for both cSCC and BCC and corrected for the influence of excess mortality due to the pandemic on keratinocyte carcinoma incidence. Results The number of diagnoses of both cSCC and BCC decreased significantly when compared to the number of diagnoses expected during March to May 2020 (cSCC -29%, BCC -50%, p<0.001). These decreases were observed across all age groups (particularly in older patients), both sexes, and all regions. In June to September the number of cSCC and BCC diagnoses was higher than expected, after which it slightly dropped below expected again in October to December. Total 2020 keratinocyte carcinoma diagnoses continued to trail those expected, with a backlog of around 1150 cSCCs and 11767 BCCs remaining at the end of the year. Conclusion Diagnosis of keratinocyte carcinoma was suboptimal during the COVID-19 pandemic, with diagnostic delays likely resulting from both patient and health system related delay. Further studies will need to determine the effects of these diagnostic delays on outcomes.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Health Sciences MSc (66851)
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