Yuji Yamada1, Daiki Kobayashi2, Keita Terashima1, Chikako Kiyotani1, Ryuji Sasaki3, Nobuaki Michihata2, Toru Kobayashi4, Hideki Ogiwara5, Kimikazu Matsumoto1, Akira Ishiguro2. 1. Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan. 2. Center for Postgraduate Education and Training, National Center for Child Health and Development, Tokyo, Japan. 3. Division of Pediatric Emergency and Transport Services, National Center for Child Health and Development, Tokyo, Japan. 4. Department of Management and Strategy, Clinical Research Center, National Center for Child Health and Development, Tokyo, Japan. 5. Division of Neurosurgery, National Center for Child Health and Development, Tokyo, Japan.
Abstract
BACKGROUND: A prolonged interval between onset of symptoms and diagnosis of childhood brain tumor is associated with worse neurological outcomes. The objectives of this study are to determine factors contributing to diagnostic delay and to find an interventional focus for further reduction in the interval between symptom onset and diagnosis in Japan. METHODS: We retrospectively analyzed 154 patients younger than 18 years with newly diagnosed brain tumors who visited our institution from January 2002 to March 2013. RESULTS: The median age at diagnosis was 6.2 years and the median total diagnostic interval (TDI) was 30 days. Patients with low-grade tumors and cerebral midline tumor location had significantly long TDI. Durations between the first medical consultation and diagnosis (diagnostic interval, DI) were exceedingly longer for patients with visual, hearing, or smelling abnormalities as the first symptom (median, 303 days). TDI and DI of patients who visited ophthalmologists or otolaryngologist for the first medical consultation were significantly longer. Among these patients, longer DI was associated with worse visual outcome. CONCLUSION: Raising awareness of brain tumor diagnosis among ophthalmologists and otolaryngologists may reduce diagnostic delay and may improve the neurological impairment of children with brain tumors in Japan.
BACKGROUND: A prolonged interval between onset of symptoms and diagnosis of childhood brain tumor is associated with worse neurological outcomes. The objectives of this study are to determine factors contributing to diagnostic delay and to find an interventional focus for further reduction in the interval between symptom onset and diagnosis in Japan. METHODS: We retrospectively analyzed 154 patients younger than 18 years with newly diagnosed brain tumors who visited our institution from January 2002 to March 2013. RESULTS: The median age at diagnosis was 6.2 years and the median total diagnostic interval (TDI) was 30 days. Patients with low-grade tumors and cerebral midline tumor location had significantly long TDI. Durations between the first medical consultation and diagnosis (diagnostic interval, DI) were exceedingly longer for patients with visual, hearing, or smelling abnormalities as the first symptom (median, 303 days). TDI and DI of patients who visited ophthalmologists or otolaryngologist for the first medical consultation were significantly longer. Among these patients, longer DI was associated with worse visual outcome. CONCLUSION: Raising awareness of brain tumor diagnosis among ophthalmologists and otolaryngologists may reduce diagnostic delay and may improve the neurological impairment of children with brain tumors in Japan.
Authors: Sophie Wilne; Karin Koller; Jacqueline Collier; Colin Kennedy; Richard Grundy; David Walker Journal: Arch Dis Child Date: 2010-04-06 Impact factor: 3.791
Authors: D Weller; P Vedsted; G Rubin; F M Walter; J Emery; S Scott; C Campbell; R S Andersen; W Hamilton; F Olesen; P Rose; S Nafees; E van Rijswijk; S Hiom; C Muth; M Beyer; R D Neal Journal: Br J Cancer Date: 2012-03-13 Impact factor: 7.640