Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Apr 2;108(6):1280-7.
doi: 10.1038/bjc.2013.88. Epub 2013 Feb 28.

Childhood cancer and factors related to prolonged diagnostic intervals: a Danish population-based study

J M Ahrensberg  1 , F Olesen, R P Hansen, H Schrøder, P Vedsted
Affiliations

Childhood cancer and factors related to prolonged diagnostic intervals: a Danish population-based study

J M Ahrensberg et al. Br J Cancer. .

Abstract

Background: Early diagnosis of childhood cancer provides hope for better prognoses. Shorter diagnostic intervals (DI) in primary care require better knowledge of the association between presenting symptoms, interpretation of symptoms and the wording of the referral letter.

Methods: A Danish nationwide population-based study. Data on 550 children aged <15 years with an incident cancer diagnosis (January 2007-December 2010) were collected through questionnaires to parents (response rate=69%) and general practitioners (GPs) (response rate=87%). The DI from the first presentation in general practice until diagnosis was categorised as short or long based on quartiles. Associations between variables and long DIs were assessed using logistic regression.

Results: The GPs interpreted symptoms as 'vague' in 25.4%, 'serious' in 50.0% and 'alarm' in 19.0% of cases. Symptom interpretation varied by cancer type (P<0.001) and was associated with the DI (P<0.001). Vomiting was associated with a shorter DI for central nervous system (CNS) tumours, and pain with a longer DI for leukaemia. Referral letter wording was associated with DI (P<0.001); the shortest DIs were observed when cancer suspicion was raised in the letter.

Conclusion: The GPs play an important role in recognising early signs of childhood cancer as their symptom interpretation and referral wording have a profound impact on the diagnostic process.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Flowchart.
See this image and copyright information in PMC

References

    1. Ansell P, Johnston T, Simpson J, Crouch S, Roman E, Picton S. Brain tumor signs and symptoms: analysis of primary health care records from the UKCCS. Pediatrics. 2010;125:112–119. - PubMed
    1. Barros AJ, Hirakata VN. Alternatives for logistic regression in cross-sectional studies: an empirical comparison of models that directly estimate the prevalence ratio. BMC Med Res Methodol. 2003;3:21. - PMC - PubMed
    1. Bjerager M.2006Delay in diagnosis and treatment of lung cancerThesisResearch Unit and Department of General Practice, Faculty of Health Sciences, University of Aarhus: Aarhus, Denmark
    1. Dang-Tan T, Trottier H, Mery LS, Morrison HI, Barr RD, Greenberg ML, Franco EL. Delays in diagnosis and treatment among children and adolescents with cancer in Canada. Pediatr Blood Cancer. 2008;51:468–474. - PubMed
    1. DerKinderen DJ, Koten JW, Van Romunde LK, Nagelkerke NJ, Tan KE, Beemer FA, Den OW. Early diagnosis of bilateral retinoblastoma reduces death and blindness. Int J Cancer. 1989;44:35–39. - PubMed

Publication types

LinkOut - more resources