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Factors affecting diagnosis of primary pediatric central nervous system neoplasias in a developing country

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Abstract

Purpose

Understand the variables that could interfere with diagnosis and prompt treatment in CNS childhood cancer in Brazil, a developing country with continental dimensions.

Methods

From 2005 to 2010, we retrospectively evaluated factors, which could represent a negative influence on the time period elapsing from the onset of symptoms until the diagnosis of the central nervous system (CNS) neoplasia in children and adolescents attended in our service.

Results

Two hundred seventeen records were analyzed retrospectively. Factors of the households were evaluated, and this data was related to the time period elapsing from presentation of the first symptoms until the diagnosis of CNS neoplasia. The average time elapsed from the onset of the symptoms until seeking medical assistance was 96 days, and from medical assistance to patient referral to a reference service was 33 days. The symptoms which most contributed to a shorter delay in diagnosis were changes in gait and paresis, mother’s occupation, father’s education level, patient gender, and living in the state of São Paulo. Besides that, variables such as male gender, mother’s education level, and lower patient age were associated with an early diagnosis time.

Conclusion

There is great difficulty in performing early diagnosis of CNS tumors, partly due to parent’s inability to recognize signs and symptoms, and in part due to an educational deficit among healthcare professionals. Identification of measures that can minimize these causes of delay is fundamental to increasing the chance of cure and survival of these patients.

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Authors and Affiliations

  1. Childhood Hematological Investigations Center Dr. Domingos A. Boldrini., Dr. Gabriel Porto St., 1270 Cidade Universitária, Campinas, SP, 13083-210, Brazil

    Isadora Olenscki Gilli, Helder Tedeschi & Enrico Ghizoni

  2. Division of Neurosurgery, Department of Neurology, University of Campinas, Tessalia Vieira de Camargo St., 126, Campinas, SP, 13083-887, Brazil

    Andrei Fernandes Joaquim, Helder Tedeschi & Enrico Ghizoni

  3. Center for Investigation in Pediatrics (CIPED), University of Campinas, Tessalia Vieira de Camargo St., 126, Campinas, SP, 13083-887, Brazil

    Simone dos Santos Aguiar & Andre Moreno Morcillo

  4. Department of Pediatrics, University of Campinas, Tessalia Vieira de Camargo St., 126, Campinas, SP, 13083-887, Brazil

    Andre Moreno Morcillo

Authors
  1. Isadora Olenscki Gilli
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  2. Andrei Fernandes Joaquim
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  3. Helder Tedeschi
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  4. Simone dos Santos Aguiar
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  5. Andre Moreno Morcillo
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  6. Enrico Ghizoni
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Corresponding author

Correspondence to Isadora Olenscki Gilli.

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Gilli, I.O., Joaquim, A.F., Tedeschi, H. et al. Factors affecting diagnosis of primary pediatric central nervous system neoplasias in a developing country. Childs Nerv Syst 35, 91–96 (2019). https://doi.org/10.1007/s00381-018-3958-8

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  • DOI: https://doi.org/10.1007/s00381-018-3958-8

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