Diagnostic delay in children with central nervous system tumors and the need to improve education

  • Ibrahim QaddoumiEmail author
  • Thomas E. Merchant
  • Fredrick A. Boop
  • Amar Gajjar
Letter to the Editor

To the Editor,

We read with interest the recent study by Patel et al. reporting delayed diagnoses in children with central nervous system (CNS) tumors, in which they reviewed a single-institution experience at Akron Children’s Hospital in Ohio [1]. The authors described a scarcity of studies on this topic in the US and cited only 1 study from Nationwide Children’s Hospital, also located in Ohio [2], but did not cite our study published a few years earlier on delayed diagnoses in children with low-grade glioma (LGG) [3].

We commend the authors for their work addressing this important topic that should be indeed further studied in the US. Although this study, like many others, did not show an effect of pre-diagnostic symptom interval (PSI) length on survival or long-term morbidity, the authors stated that shorter PSIs may decrease morbidity and cited a study from Japan suggesting that shorter PSIs yield better functional outcomes [4]. We believe it is important to address this...



The authors would like to thank Nisha Badders, PhD, for scientific editing of the final manuscript.


This work was supported, in part, by Cancer Center Support Grant CA21765 from the National Cancer Institute and by ALSAC.

Compliance with ethical standards

Conflict of Interest

Authors have no conflict of interest to report.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


  1. 1.
    Patel V, McNinch NL, Rush S (2019) Diagnostic delay and morbidity of central nervous system tumors in children and young adults: a pediatric hospital experience. J Neurooncol 143:297–304CrossRefGoogle Scholar
  2. 2.
    Coven SL, Stanek JR, Hollingsworth E, Finlay JL (2018) Delay in diagnosis for children with newly diagnosed central nervous system tumors. Neurooncol Pract 5:227–233PubMedPubMedCentralGoogle Scholar
  3. 3.
    Arnautovic A, Billups C, Broniscer A, Gajjar A, Boop F, Qaddoumi I (2015) Delayed diagnosis of childhood low-grade glioma: causes, consequences, and potential solutions. Childs Nerv Syst 31:1067–1077CrossRefGoogle Scholar
  4. 4.
    Fukuoka K, Yanagisawa T, Suzuki T, Shirahata M, Adachi JI, Mishima K, Fujimaki T, Matsutani M, Nishikawa R (2014) Duration between onset and diagnosis in central nervous system tumors: impact on prognosis and functional outcome. Pediatr Int 56:829–833CrossRefGoogle Scholar
  5. 5.
    HeadSmart Be Brain Tumour Aware (2016) A new clinical guideline from the Royal College of Paediatrics and Child Health with a national awareness campaign accelerates brain tumor diagnosis in UK children–”HeadSmart: Be Brain Tumour Aware”. Neuro Oncol 18:445–454CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Global Pediatric MedicineSt. Jude Children’s Research HospitalMemphisUSA
  2. 2.Department of Radiation OncologySt. Jude Children’s Research HospitalMemphisUSA
  3. 3.Department of SurgerySt. Jude Children’s Research HospitalMemphisUSA
  4. 4.Department of OncologySt. Jude Children’s Research HospitalMemphisUSA

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