---
title: "COVID-19 Impact on Melanoma Incidence and Prognostic Features in Sweden and Victoria, Australia"
id: "pubmed-42082381"
canonical_url: "https://medichelpline.com/clinical-feed/pubmed-42082381"
content_type: "clinical_feed_article"
specialty: "Oncology"
source_name: "PubMed / NCBI"
source_url: "https://pubmed.ncbi.nlm.nih.gov/42082381/"
doi: "10.1093/bjd/ljag172"
published_at: "2026-09-18T00:00:00.000Z"
evidence_level: "Journal Article"
license: "CC-BY-NC-4.0 / Informational Use"
---
# COVID-19 Impact on Melanoma Incidence and Prognostic Features in Sweden and Victoria, Australia
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/pubmed-42082381
- **Specialty:** [Oncology](https://medichelpline.com/clinical-feed/oncology.md)
- **Primary Source:** PubMed / NCBI
- **Source URL:** [Original Journal Publication](https://pubmed.ncbi.nlm.nih.gov/42082381/)
- **DOI:** [10.1093/bjd/ljag172](https://doi.org/10.1093%2Fbjd%2Fljag172)
- **Published At:** 2026-09-18T00:00:00.000Z
- **Evidence Rating:** Journal Article
## Executive GIST (TL;DR)
- Study compared changes in **melanoma** incidence and prognostic factors across two regions with different COVID-19 control strategies: Sweden (lighter, mostly voluntary measures) and Victoria, Australia (strict, prolonged lockdowns). - Retrospective population-based registry analysis used SweMR (Sweden) and the Cancer Council in Victoria, including incident invasive melanomas diagnosed 2013–2021; 1 March 2020 was used as the interruption point for ‘before’ vs ‘during’ COVID. - Monthly incidence rates were modelled accounting for long-term trends and seasonality; regression models assessed prognostic variables: **Breslow thickness**, **ulceration**, and lymph node status. - Both regions experienced a significant immediate drop in overall melanoma incidence at COVID onset, primarily driven by declines in thin melanomas; the drop was most pronounced among older age groups. - In Victoria the reduction in diagnoses persisted with no return to the prior slope, and decline occurred across all age groups, most notably patients <50 years; median **Breslow thickness** stayed at 0.7 mm but distribution shifted, with an 8% increase in geometric mean ratio (95% CI 5–12). - In Sweden thickness measures were unchanged overall, but odds of **ulceration** increased slightly (OR 1.09, 95% CI 1.01–1.19); lymph node metastasis rates remained stable in both regions. - The findings suggest both delayed detection of potentially harmful melanomas and reduced detection of likely indolent lesions (overdiagnosis) contributed to observed changes; Victoria showed a more sustained impact, possibly linked to stricter control measures. - Authors conclude maintaining access to timely skin checks while avoiding unnecessary investigations is important to prioritize care for melanomas most likely to cause harm.
## Clinical Analysis & Structured Key Points
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Affiliations Expand ### Affiliations * 1 Dermatology and Venereology, Department of Clinical Sciences, Lund University; and Department of Dermatology, Skåne University Hospital, Sweden. * 2 Lund Melanoma Study Group, Department of Clinical Sciences, Lund University, Lund, Sweden. * 3 Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia. * 4 School of Public Health and Preventive Medicine, Monash University Clinical Trials Centre, Melbourne, VIC, Australia. * 5 Victorian Melanoma Service, Melbourne, VIC, Australia. * 6 Division of Surgery, Department of Clinical Sciences in Lund, Lund University, Lund; and Department of Surgery, Skåne University Hospital, Kristianstad,Sweden. * PMID: **42082381** * DOI: [ 10.1093/bjd/ljag172 ](https://doi.org/10.1093/bjd/ljag172) Free article Item in Clipboard # Evaluating COVID-19 pandemic impact on melanoma incidence and prognostic factors in regions with different infection control strategies Cecilia Sand et al. Br J Dermatol. 2026. Free article Show details Display options Display options Format Abstract PubMed PMID Br J Dermatol Actions * [ Search in PubMed ](https://pubmed.ncbi.nlm.nih.gov/?term=%22Br+J+Dermatol%22%5Bjour%5D&sort=date&sort_order=desc) * [ Search in NLM Catalog ](https://www.ncbi.nlm.nih.gov/nlmcatalog?term=%22Br+J+Dermatol%22%5BTitle+Abbreviation%5D) * [ Add to Search ](https://pubmed.ncbi.nlm.nih.gov/42082381/) . 2026 Sep 18;195(4):624-632. doi: 10.1093/bjd/ljag172. ### Authors [Cecilia Sand](https://pubmed.ncbi.nlm.nih.gov/?term=Sand+C&cauthor_id=42082381)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42082381/#short-view-affiliation-1 "Dermatology and Venereology, Department of Clinical Sciences, Lund University; and Department of Dermatology, Skåne University Hospital, Sweden.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42082381/#short-view-affiliation-2 "Lund Melanoma Study Group, Department of Clinical Sciences, Lund University, Lund, Sweden."), [Dilki Jayasinghe](https://pubmed.ncbi.nlm.nih.gov/?term=Jayasinghe+D&cauthor_id=42082381)[ 3 ](https://pubmed.ncbi.nlm.nih.gov/42082381/#short-view-affiliation-3 "Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia."), [Rory Wolfe](https://pubmed.ncbi.nlm.nih.gov/?term=Wolfe+R&cauthor_id=42082381)[ 4 ](https://pubmed.ncbi.nlm.nih.gov/42082381/#short-view-affiliation-4 "School of Public Health and Preventive Medicine, Monash University Clinical Trials Centre, Melbourne, VIC, Australia."), [Victoria Mar](https://pubmed.ncbi.nlm.nih.gov/?term=Mar+V&cauthor_id=42082381)[ 5 ](https://pubmed.ncbi.nlm.nih.gov/42082381/#short-view-affiliation-5 "Victorian Melanoma Service, Melbourne, VIC, Australia."), [Karolin Isaksson](https://pubmed.ncbi.nlm.nih.gov/?term=Isaksson+K&cauthor_id=42082381)[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42082381/#short-view-affiliation-2 "Lund Melanoma Study Group, Department of Clinical Sciences, Lund University, Lund, Sweden.")[ 6 ](https://pubmed.ncbi.nlm.nih.gov/42082381/#short-view-affiliation-6 "Division of Surgery, Department of Clinical Sciences in Lund, Lund University, Lund; and Department of Surgery, Skåne University Hospital, Kristianstad,Sweden."), [Åsa Ingvar](https://pubmed.ncbi.nlm.nih.gov/?term=Ingvar+%C3%85&cauthor_id=42082381)[ 1 ](https://pubmed.ncbi.nlm.nih.gov/42082381/#short-view-affiliation-1 "Dermatology and Venereology, Department of Clinical Sciences, Lund University; and Department of Dermatology, Skåne University Hospital, Sweden.")[ 2 ](https://pubmed.ncbi.nlm.nih.gov/42082381/#short-view-affiliation-2 "Lund Melanoma Study Group, Department of Clinical Sciences, Lund University, Lund, Sweden.") ### Affiliations * 1 Dermatology and Venereology, Department of Clinical Sciences, Lund University; and Department of Dermatology, Skåne University Hospital, Sweden. * 2 Lund Melanoma Study Group, Department of Clinical Sciences, Lund University, Lund, Sweden. * 3 Centre for Health Services Research, The University of Queensland, Brisbane, QLD, Australia. * 4 School of Public Health and Preventive Medicine, Monash University Clinical Trials Centre, Melbourne, VIC, Australia. * 5 Victorian Melanoma Service, Melbourne, VIC, Australia. * 6 Division of Surgery, Department of Clinical Sciences in Lund, Lund University, Lund; and Department of Surgery, Skåne University Hospital, Kristianstad,Sweden. * PMID: **42082381** * DOI: [ 10.1093/bjd/ljag172 ](https://doi.org/10.1093/bjd/ljag172) Item in Clipboard Full text links Cite Display options Display options Format Abstract PubMed PMID ## Abstract **Introduction:** The COVID-19 pandemic significantly disrupted melanoma care worldwide, raising concerns about diagnosis and treatment delays. **Objectives:** To compare changes in incidence and prognostic factors of invasive cutaneous melanomas across two regions with contrasting COVID-19 infection control strategies. **Methods:** 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, 'before COVID' and 'during COVID' (using 1 March 2020 as interruption point). **Results:** In Victoria, melanoma diagnoses declined during COVID across all age groups, most notably among patients aged < 50 years. Median Breslow thickness remained 0.7 mm, but the distribution shifted significantly (P < 0.001), with an 8% increase in geometric mean ratio [95% confidence interval (CI) 5-12]. In Sweden, measures of thickness remained unchanged during COVID, but the odds of ulceration increased slightly (odds ratio 1.09, 95% CI 1.01-1.19). 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. **Conclusions:** 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. ## Plain language summary Melanoma is a serious type of skin cancer. If detected early, treatment can prevent it from spreading. Therefore, delayed treatment could mean a worse outcome. During the COVID-19 pandemic, access to care changed. We wanted to find out if this change affected the number of diagnoses and if melanomas were more advanced at diagnosis. We did the study in two countries with differing infection control strategies. Sweden had lighter measures, mostly voluntary. Victoria, Australia, had strict, prolonged lockdowns. We gathered information from cancer registries. We compared details of 30,000 invasive melanomas diagnosed before and during the pandemic. In each country we noted the number of tumours diagnosed every month. We also noted tumour thickness (how deep it had grown) and ulceration (broken skin over the tumour). These factors are related to risk of spread. We saw that melanoma diagnoses fell when the pandemic began, especially early (thin) melanomas. In Sweden, the decline was short-lived and was mostly in older people. In Victoria, the decline lasted longer and affected all age groups. In Victoria, average tumour thickness increased. In Sweden, ulceration became more common. The rates of spread to lymph nodes did not change in either setting. Pandemic-related restrictions affected how many melanomas were diagnosed. It also delayed some diagnoses. On average this delay resulted in slightly more advanced melanomas at diagnoses. However, the delay mostly affected thin melanomas when an urgent operation is less crucial. Also, evidence suggests that some melanomas detected would not have caused illness or death. We call this ‘overdiagnosis’. Therefore, the fall in thin melanomas may be a mix of two factors. One is delayed detection of potentially dangerous melanomas and the other is fewer harmless lesions detected. These COVID strategies showed slight shifts in melanoma diagnosis, especially for early cases. We need to maintain access to timely skin checks while avoiding unnecessary investigations. Then, we can focus care on melanomas most likely to harm patients. © The Author(s) 2026. Published by Oxford University Press on behalf of British Association of Dermatologists. [PubMed Disclaimer](https://pubmed.ncbi.nlm.nih.gov/disclaimer/) ## Comment in * [ Melanoma diagnosis during COVID-19: delay, disruption and the question of overdiagnosis. ](https://pubmed.ncbi.nlm.nih.gov/42251709/) Boada A, Tejera-Vaquerizo A. Boada A, et al. Br J Dermatol. 2026 Sep 18;195(4):566-567. doi: 10.1093/bjd/ljag234. Br J Dermatol. 2026. PMID: 42251709 No abstract available. ## Similar articles * [ The impact of the COVID-19 pandemic on melanoma diagnosis: a systematic review and meta-analysis of global evidence. ](https://pubmed.ncbi.nlm.nih.gov/40770795/) Mostafavi Zadeh SM, Noroozi E, Gheytanchi E, Tajik F, Madjd Z, Ahmadvand D.Mostafavi Zadeh SM, et al.BMC Public Health. 2025 Aug 6;25(1):2684. doi: 10.1186/s12889-025-23926-3.BMC Public Health. 2025.PMID: 40770795Free PMC article. * [ Melanoma Incidence and Mortality Trends Among Patients Aged 59 Years or Younger in Sweden. ](https://pubmed.ncbi.nlm.nih.gov/39245436/) Helgadottir H, Mikiver R, Schultz K, Nielsen K, Portelli F, Lapins J, Puig S, Isaksson K.Helgadottir H, et al.JAMA Dermatol. 2024 Nov 1;160(11):1201-1210. doi: 10.1001/jamadermatol.2024.3514.JAMA Dermatol. 2024.PMID: 39245436Free PMC article. * [ Screening for Skin Cancer in Adults: An Updated Systematic Evidence Review for the U.S. Preventive Services Task Force [Internet]. ](https://pubmed.ncbi.nlm.nih.gov/27583318/) Wernli KJ, Henrikson NB, Morrison CC, Nguyen M, Pocobelli G, Whitlock EP.Wernli KJ, et al.Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Jul. Report No.: 14-05210-EF-1.Rockville (MD): Agency for Healthcare Research and Quality (US); 2016 Jul. Report No.: 14-05210-EF-1.PMID: 27583318Free Books & Documents.Review. * [ Twenty years of melanoma in Victoria, Queensland, and South Australia (1997 - 2016). ](https://pubmed.ncbi.nlm.nih.gov/36645924/) Venugopal K, Youlden D, Marvelde LT, Meng R, Aitken J, Evans S, Kostadinov I, Nolan R, Thomas H, D'Onise K.Venugopal K, et al.Cancer Epidemiol. 2023 Apr;83:102321.
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