A Prospective Study on the Causes of Delayed Diagnosis of Childhood Cancer in Ibadan, Nigeria

Abstract

Outcome in cancer may be improved by early diagnosis and prompt treatment. The objectives of this study were to determine the prediagnostic intervals (lag time) in childhood cancer and the factors that influence them at the University College Hospital (UCH), Ibadan. The study was prospective and observational and involved children diagnosed with cancer from July 2012 to June 2014 at UCH, Ibadan, Nigeria. A history of the illness was obtained and physical examination performed on each patient. Information obtained and analyzed included sociodemographic data, cancer diagnosis and stage, time intervals between onset of symptoms and diagnosis, and the reasons for delayed diagnosis. A total of 91 children were studied, comprising 46 males and 45 females. Their ages ranged from 1 month to 15.0 years, with a median of 4.0 years. Median parent lag time was 2.0 weeks, median health system or physician lag time 8.0 weeks, and median overall lag time 15.5 weeks. Overall lag time had a negative correlation with age of child at diagnosis, a positive correlation with the number of health facilities visited before diagnosis, and was shorter in mothers younger than 40 years of age. Lag time was significantly different among the diagnostic tumor categories, with Burkitt lymphoma having short times and retinoblastoma with long times. Delayed diagnosis of childhood cancer is a significant problem in Ibadan. Education of parents and health workers on early presentation and accurate diagnosis are recommended.

Improving outcomes in cancer diagnosis, prevention and control: barriers, facilitators and the need for health literacy in Ibadan Nigeria

“…Consistent with results from previous studies, we found that awareness of cancers is high , although gaps exist in knowledge of linkages between modifiable and non‐modifiable factors and susceptibility to risk. Such knowledge is critical to enable individuals to take preventive action for enhancing their wellbeing.…”

Cancer in Youth Living With HIV (YLWHIV): A Narrative Review of the Access to Oncological Services Among YLWHIV and the Role of Economic Strengthening in Child Health

“…Lack of affordable local treatments options are amplified by long distances to treatment centers and transportation difficulties (38,39). Clinical care and transportation costs also play major roles in patient delay.…”

“…Studies highlight mismanagement of cancer cases at lower level facilities as a key weakness in health care systems which contributes to late stage of presentation and poor outcomes among children (40). Relatedly, parents who sought alternative sources of care had perceptions of unsatisfactory management by respective health facilities and a lack of confidence in health care systems (39). Alternative treatments were also sought due to the cost of modern medicine and the belief that alternative medicine had fewer side effects (41).…”

“…Patients with younger mothers were more likely to seek treatment earlier vs. those with older mothers. This was attributed to younger mothers having less experience in taking care of children and therefore being more likely to seek medical attention earlier (39).…”

Application of electrochemical aptasensors in detection of cancer biomarkers

“…Annually, millions of cancer cases are found in the world. At the early stages, the diagnosis of cancerous cells are limited and complicated [12][13][14][15] ; One of the main problems in the cancer treatment is the lack of a suitable method for early diagnosis 16,17 . The big challenge associated with various cancers is the delayed diagnosis and the occurrence of metastasis 18,19 .…”