P147 Exploring the impact of age and deprivation on malignant melanoma diagnoses during the COVID-19 pandemic in England: a national retrospective cohort study

Abstract Diagnoses of cancers in all body sites were reduced in England during the COVID-19 pandemic. Older populations were advised to stay at home due to greater risk of mortality from COVID-19, and more deprived populations had more difficulty in accessing healthcare services. This study investigated whether older and more deprived populations had greater reductions in malignant melanoma (MM) diagnoses during the pandemic. Data were retrieved from the Rapid Cancer Registration Dataset (RCRD) between January 2019 and December 2023, by five age groups and five deprivation quintiles. Deprivation was recorded by means of the Index of Multiple Deprivation (IMD), with quintiles ranging from IMD1 (most deprived) to IMD5 (least deprived). MM counts and crude incidence rates (CIRs) with 95% confidence intervals (CIs) were reported. Incidence rate ratios (IRRs) and P-values were derived using the Poisson exact method. Comparing MM diagnoses during April to June 2020 (first lockdown) and April to June 2019, the greatest changes seen were a 42% reduction in diagnoses among people aged 60–69 years and a 58% reduction in the IMD2 quintile. Annual incidence data for 2020 vs. 2019 showed the greatest reductions in the age group 60–69 years (IRR 0.77, 95% CI 0.72–0.81) and in the most deprived IMD1 quintile (IRR 0.74, 95% CI 0.69–0.80). However, significant reductions were seen across all age groups and deprivation quintiles, with no clear pattern relating to either variable. More recently, 2022 vs. 2019 showed the greatest increases in MM diagnosis, in people aged 70–79 years (IRR 1.19, 95% CI 1.14–1.27) and > 80 years (IRR 1.20, 95% CI 1.14–1.27). In 2023 vs. 2019, this increase continued for people aged 70–79 years (IRR 1.48, 95% CI 1.41–1.55) and > 80 years (IRR 1.26, 95% CI 1.20–1.33); however, there was also a significant small reduction in patients aged 0–49 years (IRR 0.93, 95% CI 0.87–0.97). No trends in MM diagnoses between 2021 and 2023 across deprivation quintiles were observed. The first lockdown period in 2020 saw the greatest impact on overall MM incidence. Although in 2020 the greatest reduction was seen in people aged 60–69 years and the most deprived, overall, there was no clear trend across deprivation quintiles or age groups, and the following years appeared to follow prepandemic trends of rising incidence in older patients. The lack of a clear pattern highlights the complexity of pandemic-related disruptions to healthcare services. Future research should explore interactions between geographies, ethnicity and gender, alongside age and deprivation, by MM stage at presentation and survival, to fully understand the long-term consequences of service interruptions and inform future national emergency strategies.