Bryan T. Carroll’s research while affiliated with Case Western Reserve University and other places

The COVID-19 pandemic affected the timely diagnosis and treatment of many cancers, including melanoma, the fifth most common cancer in the U.S. This study aimed to quantify the disruption and recovery of melanoma detection, treatment, survival, and mortality during the pandemic by analyzing data from the Surveillance, Epidemiology, and End Results (SEER) program from 2000 to 2021. Our epidemiological analysis found that melanoma incidence initially dropped by 14.8% (95% CI: − 17.2 to − 12.4) in 2020 compared to pre-pandemic projections. Although incidence rates substantially recovered by 2021, an estimated 10,274 patients (95% CI: − 12,824 to − 7,724) remained undiagnosed due to pandemic-related disruptions. Time-to-treatment and 1-year survival were mostly consistent with pre-pandemic trends, while melanoma-specific mortality modestly declined by 4.5% (95% CI: − 14.6 to 5.6) in 2021, though this was statistically non-significant. These findings suggest that healthcare systems adapted to the challenges posed by the pandemic, maintaining essential cancer services. However, the significant drop in melanoma diagnoses likely contributed to the observed reduction in mortality. Thus, re-establishing care for patients missed during the pandemic will be crucial to preventing a future increase in advanced-stage melanoma and related deaths. Supplementary Information The online version contains supplementary material available at 10.1007/s00403-024-03751-1.

Background Understanding shared characteristics underlying reported tumor seeding episodes can reveal when tumor seeding is most likely to occur and guide clinical decision making. Our goal was to systematically review tumor seeding across specialties and determine what types of instrumentation and primary tumor histology are associated with tumor seeding. Methods A systematic review was conducted using PubMed and Web of Science, per PRISMA guidelines. Publications ranged from 1965 to 2022, and studies with five or more reports of seeding were included. Papers were sorted by specialty and assigned a PRISMA Level of Evidence, and data analysis was conducted based on whether each paper supported the clinical significance of seeding. Results 7,165 papers were screened with 156 papers included for analysis. Overall, there were 8,161 cases of tumors seeding across specialties with the majority from general surgery, gastroenterology, and urology. Laparoscopy (n=1,561) and needle biopsy (n=3,448) were most frequently implicated, and carcinomas (n=5,778) and adenocarcinomas (n=1,090) were the most common primary tumor types. Discussion Upon review of the most updated (2023) versions of the NCCN and NICE guidelines across all cancer types, there were identified gaps in the coverage of tumor seeding within these guidelines, with tumor seeding being entirely absent from certain guidelines and partially absent from others. Conclusions Given the high cumulative reports of seeding and the deadly and disseminated nature of secondary disease, it is important to consider seeding risk when manipulating tumors and to modify current cancer care guidelines (NCCN/NICE) to ensure that they appropriately address seeding risk.

Importance The COVID-19 pandemic impacted the timely diagnosis of cancer, which persisted as the second leading cause of death in the US throughout the pandemic. Objective To evaluate the disruption and potential recovery in cancer detection during the first (2020) and second (2021) years of the COVID-19 pandemic. Design, Setting, and Participants This cross-sectional study involved an epidemiologic analysis of nationally representative, population-based cancer incidence data from the Surveillance, Epidemiology, and End Results (SEER) Program. Included patients were diagnosed with incident cancer from January 1, 2000, through December 31, 2021. The analysis was conducted in May 2024 using the April 2024 SEER data release, which includes incidence data through December 31, 2021. Exposures Diagnosis of cancer during the first 2 years of the COVID-19 pandemic (2020, 2021). Main Outcomes and Measures Difference between the expected and observed cancer incidence in 2020 compared with 2021, with additional analyses by demographic subgroups (sex, race and ethnicity, and age group) and community (county-level) characteristics. Results The analysis included 15 831 912 patients diagnosed with invasive cancer between 2000 and 2021, including 759 810 patients in 2020 and 825 645 in 2021. The median age was 65 years (IQR, 56-75 years), and 51.0% were male. The percentage difference between the expected and observed cancer incidence was −8.6% (95% CI, −9.1% to −8.1%) in 2020, with no significant difference in 2021 (−0.2%; 95% CI, −0.7% to 0.4%). These translated to a cumulative (2020-2021) deficit in observed vs expected cases of −127 931 (95% CI, −139 206 to −116 655). Subgroup analyses revealed that incidence rates remained substantially depressed from expected rates into 2021 for patients living in the most rural counties (−4.9%; 95% CI, −6.7% to −3.1%). The cancer sites with the largest cumulative deficit in observed vs expected cases included lung and bronchus (−24 940 cases; 95% CI, −28 936 to −20 944 cases), prostate (−14 104 cases; 95% CI, −27 472 to −736 cases), and melanoma (−10 274 cases; 95% CI, −12 825 to −7724 cases). Conclusions and Relevance This cross-sectional study of nationally representative registry data found that cancer incidence recovered meaningfully in 2021 following substantial disruptions in 2020. However, incidence rates need to recover further to address the substantial number of patients with undiagnosed cancer during the pandemic.