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COVID-Related Delays Could Lead to More Late-Stage Skin Cancer Diagnoses

The back of a white, blonde woman's neck with gloves of a healthcare provider examining a mole.

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Key Takeaways

  • Dermatologists are concerned that delays in skin cancer diagnosis during the spring of 2020 as a result of the COVID-19 pandemic could lead to advanced-stage melanoma and other skin cancer diagnoses later this year.
  • If caught early, skin cancer is generally treatable—which is why screening is important.
  • Telehealth is a great option for a routine dermatology assessment. However, if you need a biopsy, you may need to go into the office.

The American Academy of Dermatology (AAD) has reported that from March to May 2020, skin cancer diagnoses in the United States dropped by an average of 46% compared to the same time in 2019.

Experts are worried that the lack of access to dermatologists during the first months of the COVID-19 pandemic has delayed timely skin cancer diagnoses, which could lead to more late-stage diagnoses being made this year.

If diagnosed early, skin cancer is generally treatable. A diagnosis at a later stage impacts a person's chances of survival.

The Research

The study analyzed 4.7 million outpatient chart reviews from 143 dermatology practices in 13 different states from January 2019 to August 2020. The results showed that the largest decrease in skin cancer diagnosis was during the month of April—the first COVID-19 peak in the U.S.

“The decrease in skin cancer diagnosis’ during the first COVID-19 peak is problematic because catching skin cancer early is key,” Darrell S. Rigel, MD, MS, FAAD, study author and clinical professor of dermatology at New York University Langone Medical Center, tells Verywell. “A two-month delay can make a big difference. It means [a] surgery will be bigger, the scare will be bigger, and there is a 50% chance of melanoma spreading if it is not caught quickly.”

How You Can Prevent Skin Cancer

Skin cancer is highly preventable if you take precautions in the sun and practice proper skin care. The AAD says there are several steps that you can take to reduce your chances of getting skin cancer.

  • Seek shade when you're out in the sun (especially when the sun's rays are strongest—typically between 10 a.m. and 2 p.m.)
  • Wear clothes that protect your skin from the sun
  • Apply a broad-spectrum, water-resistant sunscreen (SPF 30 or higher) when you are outside (even if it's cloudy)
  • Reapply sunscreen every two hours and after swimming or sweating
  • Use extra caution near water, snow, and sand (these conditions make it more likely you'll get a sunburn because the surfaces reflect the sun's damaging rays)
  • If you want the look of a tan, go for self-tanning products rather than using a tanning bed, and keep wearing sunscreen

Remember that a tan is a sign that your skin has been injured.

Perform Regular Skin Checks

Everyone is at risk for skin cancer. According to the ADA, one in five Americans will get skin cancer in their lifetime.

The good news is skin cancer is typically treatable if it's caught early. What's more, it's also a type of cancer that you can take steps to prevent.

One of the best things that you can do is perform routine skin checks on yourself—especially if you are not able to easily see a board-certified dermatologist. The AAD outlines five key steps to perform a skin self-exam:

  1. Use a full-length mirror to examine the skin on your whole body
  2. Look at your underarms, forearms, and palms
  3. Look at your legs, between toes, and the soles of your feet
  4. Use a hand mirror to examine your neck and scalp
  5. Use a hand mirror to examine your back and buttocks

If you notice new or suspicious spots on your skin or spots that are growing, changing, itching, or bleeding, you should see a board-certified dermatologist for further assessment. 

Telehealth Promotes Early Detection

When providers' offices closed in the spring of 2020, many healthcare providers turned to telehealth to continue caring for patients, including many dermatology offices. 

According to the AAD, telehealth can be beneficial in the dermatology setting. Patients can have a video or phone conference with the dermatologist, send information via email, or use a patient portal to communicate with providers.

Telehealth in dermatology is also beneficial in other ways, such as:

  • Patients can see a board-certified dermatologist even when they can’t leave their home or they live in a remote area.
  • A dermatologist can examine a patient's skin, hair, or nail problem through video or photos.
  • If a dermatologist thinks a spot could be a potential melanoma, needs to be tested, or should be removed, they can ask a patient to come to the office for an in-person appointment.
  • Patients can have treatment for a chronic skin condition, like psoriasis or eczema, maintained.
  • Patients can be prescribed medication for a skin condition, if necessary.
  • Patients can receive dermatologic care when it's convenient. Through telemedicine, some patients can communicate back and forth with their dermatologist electronically, meaning they do not necessarily have to be available at the same time.

When Telehealth Is Not Enough

Telehealth can be very convenient for minor skin issues, but it has limitations. Rigel says that you cannot perform a biopsy virtually. If a spot or skin condition is deemed suspicious, a patient will likely need to come to the office for more testing to make a conclusive diagnosis. 

What This Means For You

When detected early, skin cancer is generally treatable. However, with delays in screening amid the COVID-19 pandemic, people might be getting a skin cancer diagnosis at a later stage of the disease, which can impact their chances of survival.

There are steps you can take to prevent skin cancer, such as covering up when you're in the sun, using sunscreen, and performing regular checks if your skin at home. If you are worried about any abnormalities you find, make an appointment with a board-certified dermatologist.

You might be able to have an initial assessment via telehealth. If a biopsy is needed, you will likely need to go to the office.

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Article Sources
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  1. Marson JW, Maner BS, Harding TP, Meisenheimer VII J, Solomon JA, Leavitt M, et al. The magnitude of COVID-19’s effects on the timely management of melanoma and non-melanoma skin cancers. Journal of the American Academy of Dermatology. 2021. doi.org/10.1016/j.jaad.2020.12.065

  2. American Academy of Dermatology (AAD). Prevent skin cancer. Updated February 7, 2021.

  3. American Academy of Dermatology (AAD). Do you know how to spot skin cancer?. Updated February 7, 2021.

  4. American Academy of Dermatology (AAD). Detect skin cancer: How to perform a skin self-exam. Updated February 7, 2021.

  5. American Academy of Dermatology Association. Detect skin cancer: how to perform a skin self-exam.

  6. American Academy of Dermatology (AAD). Telemedicine overview. Updated February 7, 2021.