From Symptom to Diagnosis—The Prediagnostic Symptomatic Interval of Pediatric Central Nervous System Tumors in Austria

Azizi, Amedeo A.; Heßler, Kirsten; Leiss, Ulrike; Grylli, Chryssa; Chocholous, Monika; Peyrl, Andreas; Gojo, Johannes; Slavc, Irene

doi:10.1016/j.pediatrneurol.2017.08.006

Cited by 31 publications

(41 citation statements)

References 32 publications

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“…5 Reports from other countries in recent decades have found TDIs to be in the range of 2.9-32.9 weeks, with the shortest reported in Japan and the longest in the eastern provinces of Canada. 5,12,[16][17][18][19][20][21][22] Regarding the situation in less developed countries, there are few and limited reports describing challenges in access to diagnostic facilities and neuro-oncological expertise. 23,24 In our current study, we found that younger age was associated with shorter TDIs, whereas sex was not.…”

Section: Discussionmentioning

confidence: 99%

“…This could be compared to a TDI of 9.1 weeks (mean 25.2 weeks) in the United Kingdom prior to the launch of an awareness campaign versus 6.7 weeks (mean 21.3 weeks) afterwards 5 . Reports from other countries in recent decades have found TDIs to be in the range of 2.9–32.9 weeks, with the shortest reported in Japan and the longest in the eastern provinces of Canada 5,12,16–22 . Regarding the situation in less developed countries, there are few and limited reports describing challenges in access to diagnostic facilities and neuro‐oncological expertise 23,24 .…”

Section: Discussionmentioning

confidence: 99%

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Prospective registration of symptoms and times to diagnosis in children and adolescents with central nervous system tumors: A study of the Swedish Childhood Cancer Registry

Rask

Nilsson

Lähteenmäki

et al. 2022

Pediatric Blood & Cancer

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Background The elapsed time taken to diagnose tumors of the central nervous system in children and adolescents varies widely. The aim of the present study was to investigate such diagnostic time intervals at a national level in Sweden as they correlate with clinical features. Methods Data prospectively accumulated over a 4‐year period in the Swedish Childhood Cancer Registry from patients aged 0–18 years were pooled, and diagnostic time intervals were analyzed considering tumor location, tumor type, patient age and sex, initial symptoms, and clinical timelines. All six pediatric oncology centers in Sweden contributed to collection of data. Time points for calculating the total diagnostic interval (TDI) defined as the time from symptom onset to diagnosis were reported in 257 of 319 patients (81%). Results The time from symptom onset to the first healthcare consultation, median 2.6 weeks, did not vary significantly between patients categorized according to tumor type or location. The median TDI was 8.3 weeks for the 4‐year study period. Patients with optic pathway glioma (TDI 26.6 weeks), those with tumors of the spinal cord (TDI 25.9 weeks), and those with midline tumors (TDI 24.6 weeks) had the longest lead times. Additionally, older age, too few initial symptoms, and seeking initial redress outside an emergency ward were factors associated with a longer time to diagnosis. Conclusion This study identified several factors associated with delayed diagnosis of central nervous system tumors among Swedish children and adolescents. These novel data ought to help direct future efforts toward clinical improvement.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prospective registration of symptoms and times to diagnosis in children and adolescents with central nervous system tumors: A study of the Swedish Childhood Cancer Registry

Rask

Nilsson

Lähteenmäki

et al. 2022

Pediatric Blood & Cancer

View full text Add to dashboard Cite

show abstract

“…Several international studies have examined the time to diagnosis of CNS tumors in children. The median time to diagnosis varies from 20.5 days to several months [13][14][15][16][17][18][19][20][21][22] (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Presenting symptoms and time to diagnosis for Pediatric Central Nervous System Tumors in Qatar: a report from Pediatric Neuro-Oncology Service in Qatar

et al. 2020

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Introduction There are no previous published reports on primary pediatric tumors of the central nervous system (CNS) in Qatar. We undertook this retrospective cohort study to review the diagnosis of CNS tumors in children in Qatar to analyze the presentation characteristics including symptoms, referral pathways, and time to diagnosis. Methods All children registered with Pediatric Neuro-Oncology service (PNOS) were included in the study. Data from the time of diagnosis (October 2007 to February 2020) were reviewed retrospectively. Presenting symptoms were recorded and prediagnosis symptom interval (PSI) was calculated from the onset of the first symptom to the date of diagnostic imaging. Results Of the 61 children registered with PNOS during the study period, 51 were included in the final analysis. Ten children were excluded because they were either diagnosed outside Qatar (n = 7) or were asymptomatic at the time of diagnosis (n = 3). The median age was 45 (range 1-171) months. Common tumor types included low-grade glioma (LGG) (47.1%) and medulloblastoma/primitive neuroectodermal tumors (PNET) (23.5%). Nine children had an underlying neurocutaneous syndrome. Thirty-eight patients (74.5%) had at least one previous contact with healthcare (HC) professional, but 27 (52%) were still diagnosed through the emergency department (ED). Presenting symptoms included headache, vomiting (36.2%), oculo-visual symptoms (20.6%), motor weakness (18.9%), seizures, ataxia (17.2% each), irritability, cranial nerve palsies (12% each), and endocrine symptoms (10.3%). Median PSI was 28 days (range 1-845 days) for all CNS tumors. Longest PSI was seen with germ cell tumors (median 146 days), supratentorial location (39 days), and age above 3 years (30 days). Tumor characteristics of biological behavior (high-grade tumor) and location (infratentorial) were significantly associated with shorter PSI, as were presenting symptoms of ataxia, head tilt, and altered consciousness. Conclusions Although overall diagnostic times were acceptable, some tumor types were diagnosed after a significant delay. The awareness campaign, such as the "HeadSmart" campaign in the United Kingdom (UK), can improve diagnostic times in Qatar. Further research is required to better understand the reasons for the delay.

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“…Symptoms preceding BT diagnosis are non-specific, and are often initially attributed to other diseases. Advanced knowledge about common symptoms of BT in the pediatric, adolescent and young adult populations could raise awareness among the medical community [6,7].…”

Section: Introductionmentioning

confidence: 99%

Clinical presentation of young people (10–24 years old) with brain tumors: results from the international MOBI-Kids study

et al. 2020

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Introduction We used data from MOBI-Kids, a 14-country international collaborative case-control study of brain tumors (BTs), to study clinical characteristics of the tumors in older children (10 years or older), adolescents and young adults (up to the age of 24). Methods Information from clinical records was obtained for 899 BT cases, including signs and symptoms, symptom onset, diagnosis date, tumor type and location. Results Overall, 64% of all tumors were low-grade, 76% were neuroepithelial tumors and 62% gliomas. There were more males than females among neuroepithelial and embryonal tumor cases, but more females with meningeal tumors. The most frequent locations were cerebellum (22%) and frontal (16%) lobe. The most frequent symptom was headaches (60%), overall, as well as for gliomas, embryonal and 'non-neuroepithelial' tumors; it was convulsions/seizures for neuroepithelial tumors other than glioma, and visual signs and symptoms for meningiomas. A cluster analysis showed that headaches and nausea/ vomiting was the only combination of symptoms that exceeded a cutoff of 50%, with a joint occurrence of 67%. Overall, the median time from first symptom to diagnosis was 1.42 months (IQR 0.53-4.80); it exceeded 1 year in 12% of cases, though no particular symptom was associated with exceptionally long or short delays. Conclusions This is the largest clinical epidemiology study of BT in young people conducted so far. Many signs and symptoms were identified, dominated by headaches and nausea/vomiting. Diagnosis was generally rapid but in 12% diagnostic delay exceeded 1 year with none of the symptoms been associated with a distinctly long time until diagnosis.

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From Symptom to Diagnosis—The Prediagnostic Symptomatic Interval of Pediatric Central Nervous System Tumors in Austria

Cited by 31 publications

References 32 publications

Prospective registration of symptoms and times to diagnosis in children and adolescents with central nervous system tumors: A study of the Swedish Childhood Cancer Registry

Prospective registration of symptoms and times to diagnosis in children and adolescents with central nervous system tumors: A study of the Swedish Childhood Cancer Registry

Presenting symptoms and time to diagnosis for Pediatric Central Nervous System Tumors in Qatar: a report from Pediatric Neuro-Oncology Service in Qatar

Clinical presentation of young people (10–24 years old) with brain tumors: results from the international MOBI-Kids study

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