Factors affecting diagnosis of primary pediatric central nervous system neoplasias in a developing country
- 90 Downloads
Understand the variables that could interfere with diagnosis and prompt treatment in CNS childhood cancer in Brazil, a developing country with continental dimensions.
From 2005 to 2010, we retrospectively evaluated factors, which could represent a negative influence on the time period elapsing from the onset of symptoms until the diagnosis of the central nervous system (CNS) neoplasia in children and adolescents attended in our service.
Two hundred seventeen records were analyzed retrospectively. Factors of the households were evaluated, and this data was related to the time period elapsing from presentation of the first symptoms until the diagnosis of CNS neoplasia. The average time elapsed from the onset of the symptoms until seeking medical assistance was 96 days, and from medical assistance to patient referral to a reference service was 33 days. The symptoms which most contributed to a shorter delay in diagnosis were changes in gait and paresis, mother’s occupation, father’s education level, patient gender, and living in the state of São Paulo. Besides that, variables such as male gender, mother’s education level, and lower patient age were associated with an early diagnosis time.
There is great difficulty in performing early diagnosis of CNS tumors, partly due to parent’s inability to recognize signs and symptoms, and in part due to an educational deficit among healthcare professionals. Identification of measures that can minimize these causes of delay is fundamental to increasing the chance of cure and survival of these patients.
KeywordsEpidemiology Diagnosis Primary Pediatric Neoplasia
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
- 1.da BM, INCA S (2014) Monitoramento das ações de controle do câncer em crianças e adolescentes. Inf Detecção Precoce 5:1–8Google Scholar
- 2.Instituto Nacional de Câncer José Alencar Gomes da Silva C de P e V (2014) Estimate/ 2014- Cancer Incidence in BrazilGoogle Scholar
- 3.Miller TPWCMJLWAWSMD (2016) Childohood leukemia and primary prevention. HHS Public Access 317–52 . doi: https://doi.org/10.1016/j.cppeds.2016.08.004.Childhood
- 5.Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, Ohgaki H, Wiestler OD, Kleihues P, Ellison DW (2016) The 2016 World Health Organization classification of tumors of the central nervous system: a summary. Acta Neuropathol 131:803–820. https://doi.org/10.1007/s00401-016-1545-1 CrossRefGoogle Scholar
- 8.Puccini RF, Hilário MOE (2008) Sinais e sintomas em Oncologia. In: Petrilli AS, Caran EM, Cypriano M (eds) Semiologia da criança e do adolescente. Guanabara Koogan, Rio de Janeiro, pp 280–289Google Scholar
- 11.IBGE (2010) Censo Demográfico 2010. Características da População e dos Domicílios. Inst Bras Geogr e Estatística 48 . doi: 0104–3145Google Scholar
- 18.Zalewska-Szewczyk B, Zielińska E, Zakrzewski K et al Prognosis of clinical course of primary brain tumours in children in relationship to the duration and characteristic features of initial clinical symptoms. Med Wieku Rozwoj 9:567–578Google Scholar
- 20.van Berlaer G, Mortelmans K, Hubloue I (2014) PO-0297 children presenting to the emergency department with headache as primary complaint are not likely to have a brain tumour. Arch Dis Child 99:A341.2–A3A341. https://doi.org/10.1136/archdischild-2014-307384.948 CrossRefGoogle Scholar
- 21.Løhmann DJA, Sørensen P, Jørgensen J, Rosthøj S (2014) Most central nervous system tumours in children are diagnosed with little delay after admission. Dan Med J 61:A4886Google Scholar
- 22.NICE Guideline (2015) Suspected Cancer: Recognition and Referral NICE Guidel 25Google Scholar
- 23.Walker D, Grundy R, Kennedy C, et al (2013) The Brain Pathways Guideline : A Guideline To Assist Healthcare Professionals in the Assessment of Children Who May Have a Brain Tumour 2017:0–127Google Scholar
- 24.Brownstein K, Stevenson E (2007) The essential guide to brain tumors. National B, San FranciscoGoogle Scholar