{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T11:52:24Z","timestamp":1789732344693,"version":"4.0.1"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T00:00:00Z","timestamp":1777939200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>The COVID-19 pandemic significantly disrupted melanoma care worldwide, raising concerns about diagnosis and treatment delays.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare changes in incidence and prognostic factors of invasive cutaneous melanomas across two regions with contrasting COVID-19 infection control strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective population-based registry study was performed using the Swedish quality registry for cutaneous melanoma (SweMR) and the Cancer Council in Victoria, Australia. Incident invasive melanomas diagnosed between 2013 and 2021 were used for trend analyses considering the long-term underlying trends and seasonality. Regression models were used for analyses of prognostic variables (Breslow thickness, ulceration, lymph node status), comparing the time periods, \u2018before COVID\u2019 and \u2018during COVID\u2019 (using 1 March 2020 as interruption point).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In Victoria, melanoma diagnoses declined during COVID across all age groups, most notably among patients aged &amp;lt; 50\u2005years. Median Breslow thickness remained 0.7\u2005mm, but the distribution shifted significantly (P &amp;lt; 0.001), with an 8% increase in geometric mean ratio [95% confidence interval (CI) 5\u201312]. In Sweden, measures of thickness remained unchanged during COVID, but the odds of ulceration increased slightly (odds ratio 1.09, 95% CI 1.01\u20131.19). Lymph node metastasis rates were stable in both regions. A significant immediate drop in overall incidence followed COVID-19 onset in both regions, primarily driven by thin melanomas. In Victoria, the lower incidence level persisted without a subsequent slope change. In contrast, the Swedish melanoma incidence gradually realigned with the pre-COVID trend after the initial level change. The immediate incidence drop was most prominent among older age groups in both regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>COVID-19 influenced melanoma incidence and prognostic features in both Sweden and in Victoria, Australia. Reduced incidence particularly of thin melanomas and modest worsening of prognostic markers were observed. Victoria showed a more sustained impact, possibly reflecting the stricter and longer-lasting pandemic control measures.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjd\/ljag172","type":"journal-article","created":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:16:50Z","timestamp":1777637810000},"page":"624-632","source":"Crossref","is-referenced-by-count":0,"title":["Evaluating COVID-19 pandemic impact on melanoma incidence and prognostic factors in regions with different infection control strategies"],"prefix":"10.1093","volume":"195","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-6690-5412","authenticated-orcid":false,"given":"Cecilia","family":"Sand","sequence":"first","affiliation":[{"name":"Dermatology and Venereology, Department of Clinical Sciences, Lund University; and Department of Dermatology, Sk\u00e5ne University Hospital ,","place":["Sweden"]},{"name":"Lund Melanoma Study Group, Department of Clinical Sciences, Lund University , Lund ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1467-7664","authenticated-orcid":false,"given":"Dilki","family":"Jayasinghe","sequence":"additional","affiliation":[{"name":"Centre for Health Services Research, The University of Queensland , Brisbane, QLD ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2126-1045","authenticated-orcid":false,"given":"Rory","family":"Wolfe","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Monash University Clinical Trials Centre , Melbourne, VIC ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9423-3435","authenticated-orcid":false,"given":"Victoria","family":"Mar","sequence":"additional","affiliation":[{"name":"Victorian Melanoma Service , Melbourne, VIC ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karolin","family":"Isaksson","sequence":"additional","affiliation":[{"name":"Lund Melanoma Study Group, Department of Clinical Sciences, Lund University , Lund ,","place":["Sweden"]},{"name":"Division of Surgery, Department of Clinical Sciences in Lund, Lund University, Lund; and Department of Surgery, Sk\u00e5ne University Hospital , Kristianstad ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5876-0190","authenticated-orcid":false,"given":"\u00c5sa","family":"Ingvar","sequence":"additional","affiliation":[{"name":"Dermatology and Venereology, Department of Clinical Sciences, Lund University; and Department of Dermatology, Sk\u00e5ne University Hospital ,","place":["Sweden"]},{"name":"Lund Melanoma Study Group, Department of Clinical Sciences, Lund University , Lund ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,4]]},"reference":[{"key":"2026091719522545500_ljag172-B1","doi-asserted-by":"crossref","first-page":"2838","DOI":"10.3390\/cancers13112838","article-title":"Trend shifts in age-specific incidence for in situ and invasive cutaneous melanoma in Sweden","volume":"13","author":"Eriksson","year":"2021","journal-title":"Cancers (Basel)"},{"key":"2026091719522545500_ljag172-B2","author":"International Agency for Research on Cancer. Global Cancer Observatory"},{"key":"2026091719522545500_ljag172-B3","author":"Cancer Council Victoria"},{"key":"2026091719522545500_ljag172-B4","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1245\/s10434-018-6513-7","article-title":"Melanoma staging: American Joint Committee on Cancer (AJCC) 8th edition and beyond","volume":"25","author":"Gershenwald","year":"2018","journal-title":"Ann Surg Oncol"},{"key":"2026091719522545500_ljag172-B5","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/j.jaad.2022.06.1190","article-title":"Delays in the surgical treatment of melanoma are associated with worsened overall and melanoma-specific mortality: a population-based analysis","volume":"87","author":"Xiong","year":"2022","journal-title":"J Am Acad Dermatol"},{"key":"2026091719522545500_ljag172-B6","author":"Folkh\u00e4lsomyndigheten"},{"key":"2026091719522545500_ljag172-B7","author":"Australian Government Department of Health, Disability and Ageing"},{"key":"2026091719522545500_ljag172-B8","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1038\/s43018-020-0074-y","article-title":"The impact of the COVID-19 pandemic on cancer care","volume":"1","author":"Richards","year":"2020","journal-title":"Nat Cancer"},{"key":"2026091719522545500_ljag172-B9","doi-asserted-by":"crossref","first-page":"1096","DOI":"10.1016\/j.jaad.2020.12.034","article-title":"The impact of the COVID-19 pandemic on the presentation status of newly diagnosed melanoma: a single institution experience","volume":"84","author":"Shannon","year":"2021","journal-title":"J Am Acad Dermatol"},{"key":"2026091719522545500_ljag172-B10","doi-asserted-by":"crossref","first-page":"e351","DOI":"10.1111\/jdv.16555","article-title":"Estimated effect of COVID-19 lockdown on melanoma thickness and prognosis: a rate of growth model","volume":"34","author":"Tejera-Vaquerizo","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2026091719522545500_ljag172-B11","doi-asserted-by":"crossref","first-page":"305","DOI":"10.3390\/ijerph20010305","article-title":"The epidemiology of malignant melanoma during the first two years of the COVID-19 pandemic: a systematic review","volume":"20","author":"Toma","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"2026091719522545500_ljag172-B12","doi-asserted-by":"crossref","first-page":"adv00525","DOI":"10.2340\/00015555-3890","article-title":"Effects of COVID-19 lockdown on tumour burden of melanoma and cutaneous squamous cell carcinoma","volume":"101","author":"Tejera-Vaquerizo","year":"2021","journal-title":"Acta Derm Venereol"},{"key":"2026091719522545500_ljag172-B13","doi-asserted-by":"crossref","first-page":"e714","DOI":"10.1111\/jdv.17493","article-title":"Impact of the COVID-19 pandemic on melanoma diagnosis","volume":"35","author":"Gisondi","year":"2021","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2026091719522545500_ljag172-B14","doi-asserted-by":"crossref","first-page":"922","DOI":"10.1111\/jdv.18953","article-title":"The impact of the COVID-19 pandemic on the diagnosis of cutaneous melanomas: a retrospective cohort study from five European skin cancer reference centres","volume":"37","author":"Troesch","year":"2023","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2026091719522545500_ljag172-B15","doi-asserted-by":"crossref","first-page":"3734","DOI":"10.3390\/cancers16223734","article-title":"Impact of COVID-19 pandemic on delay of melanoma diagnosis: a systematic review and meta-analysis","volume":"16","author":"Pellegrini","year":"2024","journal-title":"Cancers (Basel)"},{"key":"2026091719522545500_ljag172-B16","doi-asserted-by":"crossref","first-page":"2684","DOI":"10.1186\/s12889-025-23926-3","article-title":"The impact of the COVID-19 pandemic on melanoma diagnosis: a systematic review and meta-analysis of global evidence","volume":"25","author":"Mostafavi Zadeh","year":"2025","journal-title":"BMC Public Health"},{"key":"2026091719522545500_ljag172-B17","doi-asserted-by":"crossref","first-page":"e130","DOI":"10.1111\/jdv.18512","article-title":"Reply to \u2018Impact of the French COVID-19 pandemic lockdown on newly diagnosed melanoma delay and severity\u2019 by R. Molinier et al.","volume":"37","author":"Ruggiero","year":"2023","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2026091719522545500_ljag172-B18","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1111\/bjd.21050","article-title":"Limited impact of COVID-19-related diagnostic delay on cutaneous melanoma and squamous cell carcinoma tumour characteristics: a nationwide pathology registry analysis","volume":"187","author":"Sangers","year":"2022","journal-title":"Br J Dermatol"},{"key":"2026091719522545500_ljag172-B19","first-page":"175","article-title":"Practical implications of imposing a new world standard population","volume":"13","author":"Bray","year":"2002","journal-title":"Cancer Causes Control"},{"key":"2026091719522545500_ljag172-B20","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1080\/03009734.2019.1675102","article-title":"The impact of standardized care pathway on reporting time for invasive melanoma \u2013 results from one pathology department in Sweden","volume":"124","author":"Agnarsd\u00f3ttir","year":"2019","journal-title":"Ups J Med Sci"},{"key":"2026091719522545500_ljag172-B21","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1086\/230638","article-title":"Statistical methods for comparing regression coefficients between models","volume":"100","author":"Clogg","year":"1995","journal-title":"Am J Sociol"},{"key":"2026091719522545500_ljag172-B22","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.jss.2025.02.018","article-title":"The COVID-19 pandemic and delays in melanoma treatment: a National Cancer Database study","volume":"308","author":"Chung","year":"2025","journal-title":"J Surg Res"},{"key":"2026091719522545500_ljag172-B23","doi-asserted-by":"crossref","first-page":"794","DOI":"10.1093\/bjd\/ljaf263","article-title":"Can the effects of the COVID-19 pandemic provide insights into the impact of melanoma underdiagnosis and delayed care?","volume":"193","author":"Karponis","year":"2025","journal-title":"Br J Dermatol"},{"key":"2026091719522545500_ljag172-B24","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.3390\/biomedicines11061645","article-title":"Impact of the COVID-19 pandemic on the incidence and thickness of cutaneous melanoma in Belgium","volume":"11","author":"Demaerel","year":"2023","journal-title":"Biomedicines"},{"key":"2026091719522545500_ljag172-B25","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1111\/ced.14411","article-title":"Reduction in skin cancer diagnoses in the UK during the COVID-19 pandemic","volume":"46","author":"Andrew","year":"2021","journal-title":"Clin Exp Dermatol"},{"key":"2026091719522545500_ljag172-B26","doi-asserted-by":"crossref","first-page":"2619","DOI":"10.1016\/j.jid.2025.03.009","article-title":"An overview of data analysis approaches and biases in unveiling the impact of COVID-19 on melanoma diagnosis","volume":"145","author":"Zheng","year":"2025","journal-title":"J Invest Dermatol"},{"key":"2026091719522545500_ljag172-B27","doi-asserted-by":"crossref","first-page":"350","DOI":"10.1186\/s12957-021-02468-z","article-title":"The impact of treatment delay on skin cancer in COVID-19 era: a case-control study","volume":"19","author":"Seretis","year":"2021","journal-title":"World J Surg Oncol"},{"key":"2026091719522545500_ljag172-B28","doi-asserted-by":"crossref","first-page":"103418","DOI":"10.1016\/j.annder.2025.103418","article-title":"Impact of the COVID-19 pandemic on melanoma: a retrospective study from the French clinical database of melanoma patients (RIC-Mel)","volume":"152","author":"Skowron","year":"2025","journal-title":"Ann Dermatol Venereol"},{"key":"2026091719522545500_ljag172-B29","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1177\/17456916231215272","article-title":"Health communication and behavioral change during the COVID-19 pandemic","volume":"19","author":"Albarracin","year":"2024","journal-title":"Perspect Psychol Sci"},{"key":"2026091719522545500_ljag172-B30","author":"Sveriges Kommuner och Regioner"},{"key":"2026091719522545500_ljag172-B31","doi-asserted-by":"crossref","first-page":"4181","DOI":"10.3390\/jcm11144181","article-title":"Impact of the COVID-19 pandemic on the diagnosis and prognosis of melanoma","volume":"11","author":"Martinez-Lopez","year":"2022","journal-title":"J Clin Med"},{"key":"2026091719522545500_ljag172-B32","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1111\/ijd.17401","article-title":"Impact of the COVID pandemic on melanoma thickness and ulceration: a meta-analysis","volume":"64","author":"Scharf","year":"2025","journal-title":"Int J Dermatol"},{"key":"2026091719522545500_ljag172-B33","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1245\/s10434-021-11086-8","article-title":"COVID-19 is affecting the presentation and treatment of melanoma patients in the Northeastern United States","volume":"29","author":"Davis","year":"2022","journal-title":"Ann Surg Oncol"},{"key":"2026091719522545500_ljag172-B34","doi-asserted-by":"crossref","first-page":"1820","DOI":"10.1007\/s00268-022-06623-9","article-title":"Advanced-stage melanoma at presentation following the peak of the pandemic: a COVID-19 cancer canary in a coal mine","volume":"46","author":"Lamm","year":"2022","journal-title":"World J Surg"},{"key":"2026091719522545500_ljag172-B35","doi-asserted-by":"crossref","first-page":"e762","DOI":"10.1111\/jdv.18337","article-title":"Long-term effects of the COVID-19 pandemic on malignant melanoma: increased lymph node metastases in two German dermatology clinics","volume":"36","author":"Balakirski","year":"2022","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"2026091719522545500_ljag172-B36","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1136\/bmj.38516.649537.E0","article-title":"Skin biopsy rates and incidence of melanoma: population based ecological study","volume":"331","author":"Welch","year":"2005","journal-title":"BMJ"},{"key":"2026091719522545500_ljag172-B37","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1001\/jamadermatol.2022.0139","article-title":"Estimating overdiagnosis of melanoma using trends among black and white patients in the US","volume":"158","author":"Adamson","year":"2022","journal-title":"JAMA Dermatol"},{"key":"2026091719522545500_ljag172-B38","doi-asserted-by":"crossref","first-page":"189","DOI":"10.5694\/mja2.50578","article-title":"Estimating the magnitude of cancer overdiagnosis in Australia","volume":"213","author":"Glasziou","year":"2020","journal-title":"Med J Aust"},{"key":"2026091719522545500_ljag172-B39","doi-asserted-by":"crossref","first-page":"8048","DOI":"10.1200\/JCO.2005.02.0735","article-title":"Biologic and prognostic significance of dermal Ki67 expression, mitoses, and tumorigenicity in thin invasive cutaneous melanoma","volume":"23","author":"Gimotty","year":"2005","journal-title":"J Clin Oncol"},{"key":"2026091719522545500_ljag172-B40","first-page":"59","article-title":"Growth rate of melanoma in vivo and correlation with dermatoscopic and dermatopathologic findings","volume":"1","author":"Beer","year":"2011","journal-title":"Dermatol Pract Concept"}],"container-title":["British Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjd\/advance-article-pdf\/doi\/10.1093\/bjd\/ljag172\/68209487\/ljag172.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjd\/article-pdf\/195\/4\/624\/68209487\/ljag172.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjd\/article-pdf\/195\/4\/624\/68209487\/ljag172.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T23:52:35Z","timestamp":1789689155000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjd\/article\/195\/4\/624\/8667151"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,4]]},"references-count":40,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2026,5,4]]},"published-print":{"date-parts":[[2026,9,18]]}},"URL":"https:\/\/doi.org\/10.1093\/bjd\/ljag172","relation":{},"ISSN":["0007-0963","1365-2133"],"issn-type":[{"value":"0007-0963","type":"print"},{"value":"1365-2133","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,10]]},"published":{"date-parts":[[2026,5,4]]}}}