Initial symptoms and diagnostic delay in children with brain tumors at a single institution in Japan

Abstract

Background A prolonged interval between onset of symptoms and diagnosis of childhood brain tumor is associated with worse neurological outcomes. 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 less than 18 years old 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 smell abnormalities as the first symptom (median 303 days). TDI and DI of patients who visited to ophthalmologists or otolaryngologist for the first medical consultation were significantly longer. Among these patient, longer DI was associated with worse visual outcome. Conclusion Raising awareness of brain tumor diagnosis among ophthalmologists and otolaryngologist may reduce diagnostic delay and may improve the neurological impairment of children with brain tumors in Japan. (197 words)

Diffuse intrinsic pontine gliomas: First registry effort in Mexico

“…[27][28][29] Lack of suspicion is frequent too. [30][31][32][33][34] Nevertheless, the time from symptoms to diagnosis in low-grade gliomas does not correlate with survival; in fact, it is indicative of a longer survival, which can be observed in this cohort. 35,36 Although the conventional use of MRI over CT scan has become the standard method of diagnosis, many health institutions have not made further use of spectroscopy or other new techniques due to availability, as some patients who are not in a stable condition may have to travel to undergo these tests.…”

“…Many factors have been identified regarding delayed diagnosis in low‐ and middle‐income countries, but even high‐income countries face this problem 27–29 . Lack of suspicion is frequent too 30–34 . Nevertheless, the time from symptoms to diagnosis in low‐grade gliomas does not correlate with survival; in fact, it is indicative of a longer survival, which can be observed in this cohort 35,36 …”