Factors impacting time to diagnosis in pediatric CNS tumors in Chinese children

Support Care Cancer. 2021 Jul;29(7):3633-3642. doi: 10.1007/s00520-020-05863-6. Epub 2020 Nov 12.

Abstract

Objective: This study aimed to investigate the factors impacting time to diagnosis in pediatric central nervous system tumors.

Methods: A descriptive, cross-sectional design was used in this study. A self-developed questionnaire for health-seeking behavior and influencing factors was used in children with intracranial tumors. The factors related to time to diagnosis and the long-term prognosis of children were analyzed.

Results: A total of 433 families replied to the questionnaire. The median parental interval was 50 days (range 0 ~ 884), the median diagnostic interval was 97 days (range 4 ~ 1646), and the median prediagnostic symptomatic interval (PSI) was 123 days (range 8 ~ 1844). Higher education was associated with a shorter parental interval (mother: P = 0.048; father: P = 0.035). The diagnostic interval was shortened in patients with dizziness (P = 0.022), abnormal eye movement (P = 0.034), or drowsiness (P = 0.021). A shorter PSI was observed in patients who presented with high intracranial pressure such as headache (P = 0.016), dizziness (P = 0.009), or drowsiness (P = 0.023) and those who went to a higher-level health institution or patients who went to neurology or neurosurgery department as the first medical consultation. No statistically significant difference was found in the interval time (parental interval, diagnostic interval, and PSI) regarding patients' outcomes.

Conclusion: Different time intervals showed different factors influencing the long delay in diagnosing central nervous system tumors, highlighting the need for increased awareness to improve the treatment efficacy.

Keywords: Children; Delay diagnosis; Initial symptom; Intracranial tumor.

MeSH terms

  • Central Nervous System Neoplasms / diagnosis*
  • Child
  • China
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Prognosis
  • Surveys and Questionnaires