Exploiting the Impact of Sociodemographics in the Diagnosis of Central Nervous System Tumors in Childhood

Abstract

Introduction Central nervous system (CNS) tumors are the most common solid tumors in childhood, comprising 20% of all neoplasms in that age. Besides, they constitute the biggest cause of morbidity and mortality among childhood tumors, and about two thirds of the surviving patients have sequelae. The build-up of sequelae due to neoplastic growth is directly related with the time until diagnosis. Therefore, late diagnosis has a negative influence on the prognosis.

Objective To analyze the journey of the pediatric patients with CNS tumors and their families to the reference center.

Materials and Methods The present is a retrospective, prospective cohort study based on chart analyses and questionnaire application.

Results The mean age of the patients was 8.39 years, most were male (58%), white (56%), and originated from the Southeast of Brazil (56%). A total of 83% of the patients were accompanied by their mothers, and the family income obtained was below 3 minimum wages (20%). The average time until perception of the first signs or symptoms was 48 days, the mean time from symptom perception until the first medical appointment was 30 days, and the mean time between the first medical appointment and referral to Hospital de Amor Infantojuvenil de Barretos was 315 days. The most frequently present signs and symptoms were neurological manifestations (72%), such as headaches (14.8%) and projectile vomiting (6.5%). There was an association between the medical service (public or private service) where the first medical appointment took place and the first medical specialty consulted, although it did not relate to a shorter time until diagnosis.

Conclusion The difficulties in the journey of CNS tumor pediatric patients occurred mainly due to health system flaws and medical professionals' hardships. Thus, it is essential to reinforce the importance of continued medical education and to encourage new studies that may reveal precisely where these system flaws are taking place.

Keywords

early diagnosis - pediatrics - central nervous system neoplasms

Authors' Contributions

MYL: collection and assembly of data, conception and design, data analysis and interpretation, and writing of the manuscript; LFL: final approval of the manuscript; RFF: collection and assembly of data, and data analysis and interpretation; TMVF: collection and assembly of data and data analysis and interpretation; DLQP: collection and assembly of data; WYH: conception and design and data analysis and interpretation; BMM: collection and assembly of data, conception and design, data analysis and interpretation, final approval of manuscript, and writing of the manuscript.

Publikationsverlauf

Eingereicht: 17. Juli 2024

Angenommen: 16. September 2024

Artikel online veröffentlicht:
15. Januar 2025

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