Abstract | U ožujku 2020. god. Svjetska zdravstvena organizacija proglasila je pandemiju bolesti COVID-
19 te je u središtu aktivnosti svih zdravstvenih sustava postala skrb za oboljele i borba protiv
širenja ove, do tada nepoznate bolesti. Tijekom prvih nekoliko mjeseci uvedene su brojne
javnozdravstvene mjere među kojima je socijalno distanciranje bilo jedno od najbitnijih. Sve
navedeno nerijetko je rezultiralo odgađanjem planiranih pregleda, što je moglo dovesti do
odgode u postavljanju dijagnoze zloćudnih bolesti, uključujući i zloćudne tumore kože. Stoga
je cilj ovog istraživanja bio u našoj populaciji ispitati utjecaj COVID-19 pandemije na broj
novodijagnosticiranih zloćudnih tumora kože te promjene u njihovim obilježjima.
U istraživanje su uključeni bolesnici kojima je u Klinici za dermatovenerologiju KBC Zagreb
i Medicinskog fakulteta Sveučilišta u Zagrebu u vremenskim razdobljima 01.04.–01.10.2019.
i 01.04-01.10.2020. dijagnosticiran nemelanomski zloćudni tumor kože (uključujući
bazocelularni (BCC) i planocelularni karcinom kože (SCC) ili melanom (MM). U navedenom
razdoblju 2019. god. navedene dijagnoze postavljene su u ukupno 132 bolesnika, a 2020. god.
u 53 bolesnika. S obzirom na to da je u pojedinih bolesnika istovremeno dijagnosticirano više
zloćudnih tumora kože, 2019. god. je dijagnosticirano 160 (107 BCC, 32 SCC i 21 MM), a
2020. god. 64 (38 BCC, 10 SCC i 16 MM) zloćudna tumora kože, što ukazuje na jasan trend
smanjenja broja zloćudnih umora kože u 2020. god. Niti u jednoj vrsti tumora nije dokazana
statistički značajna razlika između 2019. i 2020. god. u distribuciji oboljelih prema spolu i dobi.
U 2020. god. zabilježen je značajno veći promjer BCC (P=0,031) i MM (P=0,011) u odnosu na
2019. god. Stadij MM prema Breslowu također je bio veći u 2020. god. (P=0,029). Nadalje, u
bolesnika s NMSC razdoblje od primjećivanja kožne lezije do posjeta liječnika bilo je dulje u
2020. god. (P=0,030).
Iako rezultati ovog istraživanja mogu ukazivati na rizik kasnijeg postavljanja dijagnoze i lošije
prognoze novodijagnosticiranih zloćudnih tumora u pandemijskom razdoblju, potrebne su
daljnje studije koje bi uključile veći broj ispitanika i dulje ispitivano razdoblje kako bi se
cjelovito istražio utjecaj pandemije COVID-19 na obilježja i prognozu zloćudnih tumora kože. |
Abstract (english) | In March 2020 the World Health Organization declared a pandemic of COVID-19;
consequently, the care for COVID-19 patients and the fight against the spread of this previously
unknown disease became the focus of activity of all health systems. During the first few months,
numerous public health measures were introduced, among which social distancing was one of
the most important. All of the above often resulted in the postponement of planned medical
examinations, which could delay the diagnosis of malignant diseases, including malignant skin
tumors. Therefore, our study aimed to examine the impact of the COVID-19 pandemic on the
number of newly diagnosed malignant skin tumors and changes in their characteristics in our
population.
The study included patients who were diagnosed with a non-melanoma malignant skin tumor
(including basal cell (BCC) and squamous cell carcinoma (SCC)) or melanoma (MM) at the
Department of Dermatology and Venereology, University Hospital Center Zagreb and School
of Medicine University of Zagreb, in the periods 01.04.-01.10.2019. and 01.04-01.10.2020. In
the investigated period of 2019, the above-mentioned diagnoses were made in a total of 132
patients, and in 2020. in 53 patients. Considering that several malignant skin tumors were
diagnosed in one patient at the same time, 160 malignant skin tumors were diagnosed in 2019
(107 BCC, 32 SCC, and 21 MM), and 64 (38 BCC, 10 SCC, and 16 MM) in 2020, which
indicates a clear trend of reduction in the number of malignant skin tumors in 2020. Considering
the distribution of patients according to gender and age, no statistically significant difference
between 2019 and 2020 was proven in all types of tumors. In 2020. a significantly larger
diameter of BCC (P=0.031) and MM (P=0.011) was recorded compared to 2019. The MM
stage, according to Breslow, was also higher in 2020 (P=0.029). Furthermore, in patients with
NMSC, the period from noticing a skin lesion to visiting a doctor was longer in 2020 (P=0.030).
Although the results of this study may indicate the risk of diagnostic delay and worse prognosis
of newly diagnosed malignant tumors in the pandemic period, further studies that would include
a larger number of subjects and a more extended investigated period are needed to wholly
investigate the impact of the COVID-19 pandemic on the characteristics and prognosis of
malignant tumors. |