Time to Diagnosis and Treatment of Childhood Cancer


Outcome of childhood cancer in low middle-income countries continues to be poor. One of the proposed reasons for this poor outcome is increased time spent in diagnosis and initiation of treatment. The present study was done to quantify the magnitude and types of time intervals in management of childhood cancer. Parents of 111 children with newly diagnosed cancer were interviewed. Median total time interval for entire cohort was 58 d. The most important contributor to this total interval was Referral interval. Gender and use of alternative medicine significantly affected the total interval. Increased primary care physician sensitization for quicker referral to specialized centers may mitigate the delay and improve outcome.

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  1. 1.

    Arora RS, Eden T, Kapoor G. Epidemiology of childhood cancer in India. Indian J Cancer. 2009;46:264–73.

    CAS  Article  Google Scholar 

  2. 2.

    Neal RD, Tharmanathan P, France B, et al. Is increased time to diagnosis and treatment in symptomatic cancer associated with poorer outcomes? Systematic review. Br J Cancer. 2015;112:S92–107.

    Article  Google Scholar 

  3. 3.

    Weller D, Vedsted P, Rubin G, et al. The Aarhus statement: improving design and reporting of studies on early cancer diagnosis. Br J Cancer. 2012;106:1262–7.

    CAS  Article  Google Scholar 

  4. 4.

    Below poverty line certificate: Ministry of Electronics & Information Technology, Government of India, 2016. Available at: https://digitalindia.gov.in/content/below-poverty-line-certificate. Accessed 19 Nov 2019.

  5. 5.

    GBD 2017 Childhood Cancer Collaborators. The global burden of childhood and adolescent cancer in 2017: an analysis of the Global Burden of Disease Study 2017. Lancet Oncol. 2019;20:1211–25.

    Article  Google Scholar 

  6. 6.

    Kulkarni KP, Marwaha RK. Symptom diagnosis interval in childhood acute lymphoblastic leukemia: prognostic impact and association with clinico-demographic factors. Indian J Med Paediatr Oncol. 2012;33:188.

    Article  Google Scholar 

  7. 7.

    Handayani K, Sitaresmi MN, Supriyadi E, et al. Delays in diagnosis and treatment of childhood cancer in Indonesia. Pediatr Blood Cancer. 2016;63:2189–96.

    CAS  Article  Google Scholar 

  8. 8.

    Stefan DC, Siemonsma F. Delay and causes of delay in the diagnosis of childhood cancer in Africa. Pediatr Blood Cancer. 2011;56:80–5.

    Article  Google Scholar 

  9. 9.

    Venkatasai JP, Srinivasamaharaj S, Sneha LM, Scott JX, Baby AK, Rajan M. Pediatric hematological malignancy: identification of issues involved in the road to diagnosis. South Asian J Cancer. 2017;6:28.

    Article  Google Scholar 

  10. 10.

    Pati S, Hussain MA, Chauhan AS, Mallick D, Nayak S. Patient navigation pathway and barriers to treatment seeking in cancer in India: a qualitative inquiry. Cancer Epidemiol. 2013;37:973–8.

    Article  Google Scholar 

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Correspondence to Nishant Verma.

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This article was presented as an oral paper in PHOCON 2016 (National Conference of Pediatric Hematology Oncology Chapter of IAP) and the abstract was published in Pediatric Hematology Oncology Journal in 2016 as a part of all the conference abstracts.

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Verma, N., Bhattacharya, S. Time to Diagnosis and Treatment of Childhood Cancer. Indian J Pediatr 87, 641–643 (2020). https://doi.org/10.1007/s12098-020-03217-y

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  • LMIC
  • Childhood cancer
  • Delay
  • India