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Initial symptoms and diagnostic delay in children with brain tumors at a single institution in Japan
Yuji Yamada1, Daiki Kobayashi2, Keita Terashima1
1Children's Cancer Center, National Center for Child Health and Development, Tokyo, Japan.
Insights
Delayed diagnosis of childhood brain tumors in Japan impacts outcomes. Improving awareness among eye and ear specialists can shorten the diagnostic interval, improving neurological impairment in pediatric patients.
Area of Science:
- Pediatric Oncology
- Neurology
- Medical Diagnostics
Background:
- Prolonged intervals between symptom onset and diagnosis of childhood brain tumors correlate with poorer neurological outcomes.
- Diagnostic delays in pediatric brain tumors necessitate identifying contributing factors and intervention points.
- Understanding these delays is crucial for improving patient management and outcomes in Japan.
Purpose of the Study:
- To identify factors contributing to diagnostic delays in childhood brain tumors in Japan.
- To pinpoint areas for intervention to reduce the time from symptom onset to diagnosis.
- To improve neurological outcomes for pediatric brain tumor patients.
Main Methods:
- Retrospective analysis of 154 pediatric patients (<18 years) with newly diagnosed brain tumors.
- Data collected from January 2002 to March 2013 at a single institution.
- Evaluation of total diagnostic interval (TDI) and diagnostic interval (DI) based on presenting symptoms and initial medical consultations.
Main Results:
- Median age at diagnosis was 6.2 years, with a median total diagnostic interval (TDI) of 30 days.
- Low-grade tumors and midline cerebral locations were associated with significantly longer TDIs.
- Patients presenting with visual, hearing, or smelling abnormalities experienced a median diagnostic interval (DI) of 303 days, with longer DI linked to worse visual outcomes.
Conclusions:
- Increased awareness of brain tumor diagnosis among ophthalmologists and otolaryngologists is recommended.
- Targeted educational interventions for specialists may reduce diagnostic delays.
- Reducing diagnostic delay can potentially improve neurological outcomes for 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.
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