Abstract

The longer diagnostic intervals in low- and middle-income countries have been proposed among the possible causes of poorer outcomes in children with cancer. In this single-center study from Turkey, the diagnostic intervals and survival status of 138 children with solid tumors and lymphoma (excluding leukemia) were prospectively evaluated. The median total interval (from the beginning of the first cancer-related symptom to the first day of the cancer-specific therapy), the median patient interval (the time interval from the notification of the first cancer-related symptom to the first admission to a healthcare facility), and the median physician interval (the time interval between the first healthcare admission to the first pediatric oncology visit) were 65, 26, and 24 days, respectively. The estimated 5-year overall survival and event-free survival rates were 80.7% and 69.1%, respectively. The longer time intervals were correlated with age, paternal education, localization, and tumor type. Interestingly, none of the time parameters were found to be associated with survival on regression analysis. In conclusion, the diagnostic delay in children with cancer is multifactorial, and the patient- and disease-related factors are as important as the time intervals on survival.

Supplemental data for this article is available online at https://doi.org/10.1080/08880018.2021.1951903

摘要

低收入和中等收入国家的较长诊断间隔被认为是癌症儿童预后较差的可能原因之一。在这项来自土耳其的单中心研究中，前瞻性评估了 138 名患有实体瘤和淋巴瘤（不包括白血病）的儿童的诊断间隔和生存状态。中位总间隔（从第一个癌症相关症状开始到癌症特异性治疗的第一天），中位患者间隔（从第一个癌症相关症状通知到第一次入院的时间间隔）医疗机构），中位医师间隔（第一次医疗入院到第一次儿科肿瘤科就诊之间的时间间隔）分别为 65、26 和 24 天。估计的 5 年总生存率和无事件生存率分别为 80.7% 和 69.1%。较长的时间间隔与年龄、父亲教育、定位和肿瘤类型相关。有趣的是，在回归分析中，没有发现任何时间参数与生存率相关。总之，癌症儿童的诊断延迟是多因素的，与患者和疾病相关的因素与生存时间间隔一样重要。

本文的补充数据可在线获取 https://doi.org/10.1080/08880018.2021.1951903