Investigating the incidence and severity of head and neck non-melanoma skin cancer (H&N NMSC) post-covid pandemic using pathological staging criteria

Objectives
A service evaluation to establish whether pathological staging, margin clearance and tumour size has
worsened post-pandemic and its implications on clinical practice including screening, referral times,
treatment considerations and management of complications.
Materals and Methods
Retrospective data collection of 100 patients treated for primary H&N NMSC pre-pandemic 2013-2014
were compared to 100 patients treated post-pandemic 2020-2023. All patients were randomly selected
with a single surgeon carrying out primary surgery on all 200 patients. Tumour staging, margin
clearance, tumour size and number of lesions were recorded and will be compared pre and
post-pandemic. The British Association of Dermatology guidelines on management of basal and
squamous cell carcinoma will inform result analysis and discussion.
Results
Pre-pandemic there were 85 BCCs, 20 cSCCs, 3 Bowen’s disease, 1 Merkel cell carcinoma and 1
Trichilemmal carcinoma. Post-pandemic there were 55 BCCs, 51 SCCs, 3 Bowen’s disease and 1
Merkel cell carcinoma.
Pre-pandemic there were 81 lesions staged as pT1, 16 pT2 and none of a higher stage. Post-pandemic
there were 75 pT1, 9 pT2, 15 pT3 and 1 pT4 lesions. Pre-pandemic there were 6 well differentiated, 9
moderately differentiated and 5 poorly differentiated cSCCs. Post-pandemic there were 11 well
differentiated, 29 moderately differentiated and 9 poorly differentiated cSCCs. Statistical analysis is to
be undertaken to evaluate significance.
Conclusion
Results will be discussed at the local departmental meeting to reflect on the impact of the pandemic on
local H&N NMSC diagnosis and treatment.