The economic- and mortality-related consequences of delayed melanoma diagnoses during the COVID-19 pandemic lockdowns were described in a recent study published by Maul et al in JAMA Network Open. The pandemic resulted in limited access to certain specialists, staff shortages, and interruptions in routine procedures such as cancer screenings. Investigators used population-based data from 31 countries across Europe to identify over 50,000 patients aged 18 years and older with stage I to IV invasive primary cutaneous melanoma to assess the economic costs and premature mortality correlated with delayed melanoma diagnoses. They also determined melanoma upstaging rates, years of life lost, and total financial burden of the delayed diagnoses. The investigators estimated that there were 111,464 years of life lost (range = 52,454–295,051) and $7.65 billion total additional costs (range = $3.60–$20.65 billion) because of lockdown-related delays in melanoma diagnoses. Indirect costs accounted for 94.5% of the total costs. Additionally, there were an estimated 15,360 years lost due to disability for the 17% upstaging model—ranging from 7,228 years with the 8% upstaging model to 40,660 years with the 45% upstaging model. When combined, the total years of life lost and years lost due to disability were 126,824 disability-adjusted life-years for the 17% upstaging model, ranging from 59,682 disability-adjusted life-years with the 8% upstaging model to 335,711 disability-adjusted life-years with the 45% upstaging model. The investigators underscored the significance of continuing secondary melanoma prevention measures during pandemics and incorporating indirect economic costs in future decision-making processes.


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