Reducing the Diagnostic Time for Childhood Cancer in Peru: A Hospital-Based Registry Analysis Four Years After...

Late detection is a major contributor to the high mortality of childhood cancer in low- and middle-income countries. A previous study in Peru showed that the diagnostic time (DT), the interval between the onset of symptoms and definitive diagnosis, was 107 days. Since 2019, a national strategy with multiple interventions has been implemented under the Global Initiative for Childhood Cancer (GICC). This study analyzes the reduction in DT achieved over the past four years.

Data on children and adolescents registered in the GICC hospital-based registry were retrospectively analyzed. Patients were from nine hospitals nationwide. Associations between clinical-demographic variables and DT were examined. Additional intervals analyzed were patient time (PT), medical time (MT), and treatment time (TT).

The study included 2268 patients under 20 years of age diagnosed between 2020 and 2023. Median DT was 26 days (interquartile range [IQR]: 9-61) and mean DT 57 days (SD: 97.8). Longer DT was observed in patients aged 12-20 years, those with solid tumors, and those whose parents had lower education levels. Median PT (onset to first healthcare contact) was 19.5 days (IQR: 7-44) and was longer when parents had only early or primary education. Median MT (first contact to diagnosis) was 10 days (IQR: 2-30). Compared with 2012-2014, DT significantly decreased, mainly due to shorter MT (p < 0.001), demonstrating the strategy's impact on provider-dependent intervals. Median TT (diagnosis to treatment initiation) was 8 days (IQR: 1-19), with no significant change compared with 2012-2014.

Implementation of Peru's early detection strategy within the GICC framework has markedly reduced DT, largely by improving provider diagnostic capacity. Integration of this strategy into national policies is essential to ensure its sustainability and continued improvement in childhood cancer outcomes.