ORIGINAL ARTICLE – MELANOMA COVID-19 is Affecting the Presentation and Treatment of Melanoma Patients in the Northeastern United States Catherine H. Davis, MD, MPH 1,2 , Jason Ho, BA 2 , Stephanie H. Greco, MD 3 , Vadim P. Koshenkov, MD 1,2 , Roberto J. Vidri, MD 3 , Jeffrey M. Farma, MD 3 , and Adam C. Berger, MD 1,2 1 Division of Surgical Oncology, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ; 2 Rutgers Robert Wood Johnson University Medical School, New Brunswick, NJ; 3 Division of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA ABSTRACT Background. Covid-19 significantly affected healthcare delivery over the past year, with a shift in focus away from nonurgent care. Emerging data are showing that screening for breast and colon cancer has dramatically decreased. It is unknown whether the same trend has affected patients with melanoma. Methods. This is a retrospective cohort study of mela- noma patients at two large-volume cancer centers. Patients were compared for 8 months before and after the lock- down. Outcomes focused on delay in treatment and possible resultant upstaging of melanoma. Results. A total of 375 patients were treated pre-lockdown and 313 patients were treated post-lockdown (17% decrease). Fewer patients presented with in situ disease post-lockdown (15.3% vs. 17.9%), and a higher proportion presented with stage III-IV melanoma (11.2% vs. 9.9%). Comparing patients presenting 2 months before versus 2 months after the lockdown, there was an even more sig- nificant increase in Stage III-IV melanoma from 7.1% to 27.5% (p \ 0.0001). Finally, in Stage IIIB-IIID patients, there was a decrease in patients receiving adjuvant therapy in the post lockdown period (20.0% vs. 15.2%). Conclusions. As a result of the recent pandemic, it appears there has been a shift away from melanoma in situ and toward more advanced disease, which may have significant downstream effects on prognosis and could be due to a delay in screening. Significantly patients have presented after the lockdown, and fewer patients are undergoing the recommended adjuvant therapies. Patient outreach efforts are essential to ensure that patients continue to receive preventative medical care and screening as the pandemic continues. The COVID-19 pandemic significantly affected health- care delivery over the past year, with a shift in focus toward emergent and urgent care and away from nonurgent and preventative care. Shortly following the onset of the COVID-19 in the United States, many different medical boards and societies, as well as the U.S. Surgeon General, released recommendations for the care of various types of patients during the pandemic, including cancer patients. In the setting of the COVID-19 healthcare crisis and limited resources, many activities deemed ‘‘elective’’ were delayed, including cancer screening and even surgical management of cancer patients. Widely available data exist to demonstrate that screen- ing for many cancers has dramatically decreased since the onset of the pandemic. Comparing 20 different U.S. insti- tutions from April 2020 (during COVID-19 pandemic) with April 2019 as a control, breast and colorectal cancer screening declined by 89.2% and 84.5%, respectively. 1 Other studies have likewise demonstrated the negative impact on screening of breast, colorectal, and lung can- cers. 2–4 In some reports, this has translated into fewer cancer diagnoses: endometrial cancer diagnoses are 35% Poster Presentation at the Annual Meeting of the Society of Surgical Oncology, March 2021. Ó Society of Surgical Oncology 2021 First Received: 2 August 2021 Accepted: 26 October 2021 A. C. Berger, MD e-mail: adam.berger@rutgers.edu; ab2047@cinj.rutgers.edu Ann Surg Oncol https://doi.org/10.1245/s10434-021-11086-8