Diagnostic Delay in Pediatric Cancer; Causes and Effect on Survival Rates

Background

Currently, timely diagnosis immediately followed by effective treatment is an essential approach for control of the public health burden due to childhood cancers.

Our aim was to ascertain the median lag time till diagnosis, and treatment of pediatric patients with malignancy and to determine factors influencing the delayed diagnosis and relate delay times to diagnosis with overall and event free survival rates.

Methods

A cross sectional prospective study including children and adolescents with confirmed cancer diagnosis was conducted in Pediatric Hematology –Oncology Unit of Ain Shams University Children's Hospital, Egypt. A predesigned questionnaire was structured to collect data from parents or legal guardians of patients diagnosed with cancer about demographic and cancer characteristics the latter included presenting symptoms, type, site, risk, modalities of diagnosis, time to diagnose, treatment with calculation of event free survival and overall survival times.

Results

The study enrolled 115 children and adolescents with cancer during the period from August 2020 to May 2021. Misdiagnosis was initially recorded in 16 (13.9%) patients. Median total diagnostic delay or Lag Time (LT) for all patients was 53 days. Patients’ gender, age and socioeconomic status did not affect the median total delay, whereas residency, misdiagnosis, presence of health insurance, tumor location and presence of metastasis significantly influenced the total diagnostic delay. There was no significant correlation between overall and event free survival rates and total diagnostic delay.

Conclusion

Delayed diagnosis of solid malignant neoplasms except Wilms tumor, needs more attention to health care providers awareness especially in rural regions.