Delays in diagnosing melanoma due to COVID-19 lockdown may have contributed to more than 100,000 years of life lost across Europe and over £6 billion mainly indirectly due to loss of productivity, according to new research in JAMA Network Open.
For the study, a team of researchers from the UK, Switzerland, Germany, US, Italy, Australia and Hungary, looked at the health economic consequences of delays in diagnosing melanoma. The analysis was based on information from 50,072 patients at two cancer treatment centres in Switzerland and Italy and supported by further data from the UK and Belgium.
The researchers estimated how many people’s cancer would have progressed from one stage to the next due to delays in beginning or continuing treatment, as both screening services and treatments were disrupted in 2020 and 2021 due to lockdown restrictions, staff shortages, and fear of infection. They estimated that for roughly 17% of people with melanoma, their cancer would have progressed to a higher stage in 2020-2021, due to delays in diagnosis or treatment of two to three months or longer.
The research team then estimated the additional medical costs. These cost estimates included both the direct costs to healthcare providers as well as the broader impacts such as the loss of productivity due to disability and years of life lost.
Delays to melanoma diagnoses contributed to 111,464 years of life lost across 31 countries in Europe, with a total economic cost of £6.1bn (€7.1bn or $7.7bn USD). Most of the costs (94.5%) were indirect costs such as loss of productivity.
“It’s alarming that for just one disease, there were many years of life lost, a lower quality of life for many thousands of people, and billions of pounds of economic impact – this may be just the tip of the iceberg of the consequences of delayed diagnosis and treatment due to lockdowns,” says co-lead study author Kaustubh Adhikari, PhD, a statistical geneticist of the the University College London (UCL) Genetics, Evolution & Environment and The Open University, in England.
“While the lockdowns did save many lives by mitigating the toll of Covid-19 itself, it is important that we learn from the experience to ensure that if another pandemic arises, we can effectively balance different healthcare priorities.”
Co-lead author Elisabeth Roider, MD, PhD, an attending physician and principal investigator at the University Hospital of Basel, agrees. “Our findings show that preventative healthcare always needs to be a top priority, both in normal times and in times of crisis; any plans for potential future pandemics need to consider unintended side effects on a wide range of health conditions and plan holistically,” she says. “Delays to diagnosis and treatment can be devastating to people affected by cancer, so getting prompt evaluation and treatment is vital for people concerned about their health, while screening programmes need to be treated as a priority by healthcare system leaders.”