About one-quarter of patients with keratinocyte carcinoma (KC) who had a delay in Mohs micrographic surgery (MMS) due to stay-at-home recommendations reported being more worried about their skin cancer, according to a report published online Dec. 4 in the Journal of the American Academy of Dermatology.

Emily Stamell Ruiz, M.D., M.P.H., from Harvard Medical School in Boston, and colleagues examined the impact of the COVID-19 pandemic on cancer worry in patients undergoing MMS for KC. Data were included for 191 patients whose MMS was canceled due to stay-at-home recommendations and was rescheduled from April to August 2020 (COVID delay), as well as 381 control patients who underwent MMS in May to August 2019.

The researchers found that the mean time from biopsy to treatment was 129.0 and 41.0 days in the COVID-delay and control groups, respectively. There was no significant difference in preoperative or postoperative defect size, mean number of Mohs stages, or complexity of reconstruction between the groups. The mean score for the Cancer Worry Scale was similar in all patients (45.0 and 44.7 in COVID-delay cases and controls, respectively). Overall, 22 percent of COVID-delay patients were more worried about their skin cancer and 10 percent were upset about the delay. In a univariate analysis, prior history of cutaneous squamous cell carcinoma and tumor diameter ≥20 mm was associated with being more worried about skin cancer; in a multivariate analysis, neither was significant.

These "data could be used to enhance patient-centered communication at the time of the surgical delay regarding the indolent nature of most KCs, which could alleviate cancer worry and improve the overall patient experience," the authors write.

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