GIRFT02: The influence of the COVID-19 pandemic on Breslow thickness and outpatient malignant melanoma service provision in an Irish Dermatology centre

Stephanie Bowe, Anna Wolinska, Gregg Murray, Ciara Malone, Cliona Feighery and Muireann Roche

Our Lady of Lourdes Hospital Drogheda, Drogheda, Ireland

The COVID-19 pandemic has had a dramatic impact on health services worldwide. We sought to analyse the impact of the COVID-19 pandemic on Breslow thickness (BT) and outpatient malignant melanoma (MM) cancer service provision in a dermatology centre in Ireland. We reviewed the BT of patients diagnosed at a single dermatology centre from January 2019 until July 202, which was recorded in a logbook. We assessed the numbers of patients (new or return) attending pigmented lesion (PLCs) and minor operations (MOPS) clinics during 2019, 2020 and January–July 2021. Descriptive statistics were completed using SPSS (version 24; IBM, Armonk, NY, USA). In total, 143 MMs were identified. There were 79 females (55%) and 64 males (45%). Fifty-three MMs were diagnosed in 2019, 62 in 2020 and 32 identified by July 2021. Twenty-nine invasive MMs (56%) and 23 melanoma in situ (MIS) were reported in 2019, 38 MMs (62%) and 23 MIS in 2020, and 15 MM (50%) and 15 MIS from January to July 2021. In 2019 median BT was 0.75 mm (range 0.3–12), 1.0 mm in 2020 (range 0.1–6) and 1.15 mm in 2021 up to 31 July (range 0.25–7.1). These data suggest a steady increase in BT over the last 3 years. PLCs were held at least once weekly. MOPS were held 2 days a week and could include patients seen in other dermatology clinics. PLC minor operations (PLCMINs) included patients seen that day in the PLC who then had same-day excisions or biopsies performed. The number of PLCs held was (median number of new patient attendances) 30 (20.5) from January to July 2021, 50 (15) in 2020 and 49 (25) in 2019. A total of 114 clinics were held in January–July 2021, including PLC, MINS and PLCMINs vs. 180 clinics in 2020 and 198 in 2019. There were 100 MINs scheduled in 2019 vs. 82 in 2020 and 55 in January–July 2021. Our study demonstrated that there was an increase in median BT each year from 2019 to 2021 (January–July). Possible reasons for this are manifold, and include disruption to outpatient service provision, disruption in accessing primary care providers and patient fear of attending healthcare settings. This information can guide future decisions regarding outpatient cancer services in Ireland and demonstrates that MM skin cancer provision is crucial, even during national emergencies.