St Andrew’s COVID-19 Surgery Safety (StACS) study: Skin cancer

Abstract

Background: Skin cancer represents the most common malignancy worldwide and it is imperative that we develop strategies to ensure safe and sustained delivery of cancer care which are resilient to the ongoing impact of COVID-19.Objective: This study prospectively evaluates the COVID-19 related patient risk and skin cancer management at a single tertiary referral centre, which rapidly implemented national COVID-19 safety guidelines. Method: A prospective cohort study was performed in all patients who underwent surgery for elective skin cancer service management, during the UK COVID-19 pandemic peak (April-May 2020). 'Real-time' 30-day hospital database deceased data were collected. Random selection was undertaken for patients who either underwent operative (surgery group) management or remained on the waiting list (control group); these groups were also prospectively followed-up within a controlled cohort study design and telephoned at the end of June 2020 for the control group or 30 days post-operatively. Results: Of the 767 patients who had operations, there were no COVID-19 related deaths. Both the surgery (n ¼ 384) and control (n ¼ 100) groups were matched for age, sex, ethnicity, BMI, presence of comorbidities, smoking and positive COVID-19 contact. There were no differences in post-operative versus any symptom development (1.3%, 5/384 vs. 4%, 4/100, p ¼ 0.093), or proportion of positive tests (8.6%, 33/ 384 vs. 8%, 8/100; p ¼ 0.849), between the surgery and control groups. Conclusion: These data support continued and safe service provision, and no increased risk to skin cancer patients who require surgical management, which is vital for continuation of cancer treatment in the context of a pandemic.

Impact of the COVID‐19 pandemic on international cutaneous squamous cell carcinoma incidence: A systematic review and meta‐analysis

“…In future pandemics, public health campaigns should increase NMSC awareness and mitigate fear of accessing healthcare to prevent delays in seeking medical attention and ensure all aspects of healthcare services continue to function. 70 , 71 , 72 …”

“…30 In future pandemics, public health campaigns should increase NMSC awareness and mitigate fear of accessing healthcare to prevent delays in seeking medical attention and ensure all aspects of healthcare services continue to function. [70][71][72] Lastly, alignment of NMSC epidemiology with other invasive diseases is required. Governmental support is vital in improving electronic record systems and standardised data collection globally.…”

Close and incomplete excision margins in non-melanoma skin cancer: A tertiary plastic surgery center experience

“…Our experience of treating NMSCs in our plastic surgery tertiary referral center during the recent pandemic is presented. 2 A cohort of 2221 patients who underwent 2554 NMSC excisions (1/04/2020-31/03/2021) was identified and histology data were collected; further NMSC operations occurred at peripheral sites but were excluded. Analyzed data included patient demographics, tumor site and histological parameters as reported according to national guidelines.…”