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Delay in the diagnosis of retinoblastoma in China
Shuwei Bai1, Ruojin Ren, Bin Li
1Beijing Institute of Ophthalmology, Beijing TongRen Hospital, Capital Medical University, China.
Insights
Delayed diagnosis of retinoblastoma in children is common in East Asia. This study in Beijing found diagnostic delays influenced by age, clinical presentation, and tumor stage, highlighting the need for increased awareness and improved medical infrastructure.
Area of Science:
- Ophthalmology
- Pediatric Oncology
- Medical Diagnostics
Background:
- Retinoblastoma is the most common intraocular tumor in children, with increasing prevalence in Asia.
- Early diagnosis and treatment are critical for survival and vision preservation in retinoblastoma cases.
- Limited data exists on diagnostic timelines for retinoblastoma in East Asia.
Purpose of the Study:
- To assess the time interval between symptom detection and initiation of therapy for retinoblastoma patients in Beijing.
- To identify factors contributing to diagnostic delays in pediatric retinoblastoma.
- To provide insights into the management of retinoblastoma in the East Asian context.
Main Methods:
- Retrospective analysis of 572 retinoblastoma patients treated at Beijing TongRen Eye Hospital from 1987 to 2006.
- Data collected included age, clinical appearance, histological tumor features, and time intervals from symptom onset to diagnosis and therapy.
- Statistical analysis was performed to identify factors associated with diagnostic delay.
Main Results:
- The mean delay between symptom detection and diagnosis/therapy was 4.1 ± 5.9 months.
- Diagnostic delays of 2 months or more were observed in 59% of children, and delays exceeding 6 months in 17%.
- Longer delays were significantly associated with older age groups (2-4 years), earlier study periods (1987-1991), specific clinical appearances, and histological findings.
Conclusions:
- Diagnostic delays in retinoblastoma are influenced by patient age, the period of study, and tumor characteristics.
- Improvements in parental and healthcare provider awareness, alongside enhanced medical infrastructure, are crucial for reducing diagnostic delays in China.
- Addressing these delays is vital for improving treatment outcomes and prognosis in retinoblastoma.
Purpose:
Retinoblastoma is the most frequent primary intraocular tumour and is rapidly gaining importance in Asia. As the survival is markedly dependent on early diagnosis and as information on that is not available from East Asia, we assessed the time interval between symptoms detection and therapy of children treated in the Beijing TongRen Eye Hospital.
Methods:
The retrospective study consisted of all patients who were treated in the study period from January 1987 to November 2006 in the Beijing TongRen Hospital and for whom the data on delay in diagnosis, age, clinical appearance and histological tumour features were available.
Results:
The inclusion criteria were met by 572 patients (326 boys) with a mean age of 2.6 ± 1.8. Mean interval between first detection of symptoms and clinical diagnosis and therapy was 4.1 ± 5.9 months (range: 3-36 months). A diagnostic delay of 2 months or >6 months was found for 337 (59%) children and 98 (17%) children, respectively. Diagnostic delay was significantly (p < 0.001) the longest in the 2- to 4-year-old group (5.5 ± 7.4 months). It decreased from the study period 1987-1991 to the period 2002-2006 (p < 0.001). It was significantly associated with the clinical appearance (p = 0.001) and histological finding (p = 0.008).
Conclusions:
Delay in the diagnosis of retinoblastoma depended on the age of the children, study period, and clinical and histological stage. Because the prognosis is markedly influenced by tumour stage, further improvements in the alertness of parents, family doctors and paediatricians and in the medical infrastructure in China may be addressed.
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