Evaluation of the lag time between onset of symptoms and diagnosis in childhood cancers

Abstract

Introduction: Our aim was to evaluate the lag time between the first onset of symptoms and the final diag-nosis in children with lymphoma and solid tumors.Materials and Methods: This study was carried out by retrospectively scanning the records of 759 patients admitted to the Pediatric Oncology Department of Uludag University between January 2005 and December 2014. Demographic data of the patients, first complaints, the time to apply to a physician after the first complaint, the first application center were determined, lag time to the center that established the oncologic diagnosis, the final diagnosis, time to diagnosis at the last center, total time elapsed from the first onset of complaints to the establishment of diagnosis and the last health state of the patient were obtained from the hospital records.Results: The patients diagnosed with cancer firstly applied to a physician median 15 days. The physicianwho saw the patient for the first time referred to him/her to the center that established the final diagnosis after a median of 8 days. The median time to final diagnosis was 10 days minimum 1 days and totaly 55 days at the last center. In patients whose first symptom is fever, abdominal pain and seizures and In patients with a definitive diagnosis of germ cell tumor, neuroblastoma, kidney tumor and liver tumor, the time to the first admission was shorter than 15 days. In patients whose first symptom was a headache, and abdominal mass; in patients and central nervous system (CNS), and eyes, and in patients with the final diagnosis of CNS tumor germ cell tumor and retinoblastoma, the lag times for referrals were significantly shorter than 8 days. In patients whose first symptom was headache, nausea and vomiting, fatigue-weight loss, and visual disturbances and in patients with the final diagnosis of CNS tumors and neuroendocrine tumors, the time to diagnosis was significantly shorter than 10 days.Conclusion: Delays in diagnosis are common in children with cancer. A sustained effort should be made to raise the level of awareness of childhood cancer among parents and to sensitize all physicians, especially those who treat pediatric patients infrequently, about the warning signs of the disease.