Download PDF
CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2011; 32(01): 30-33
DOI: 10.4103/0971-5851.81887
ORIGINAL ARTICLE

Childhood cancer in developing society: A roadmap of health care

P M Ramesh
Department of Pediatrics, Govt. TD Medical College, Alappuzha, Kerala, India
,
R K Marwaha
Department of Pediatrics, Hematology Oncology Division, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
,
T S Anish
Department of Community Medicine, GMC, Thiruvananthapuram, Kerala, India
› Author Affiliations
Source of Support Nil.
› Further Information
Also available at
 PDF Download Permissions and Reprints

Abstract

Background: We assessed referral patterns of children with hematological malignancies (HM) in North India. Materials and Methods: The parents/guardians were interviewed at presentation, in the period between October 2001 and November 2002. Patient delay (symptom-contact), health system delay (contact-diagnosis), total delay (symptom-diagnosis), and number of contacts were compared between high- and standard-risk disease group. Results: Of the 79 children (55 boys; 69.6%) with HM, 47 (59.5%) had Acute Lymphoblastic Leukemia (ALL). Forty-four children had high-risk disease. The patient, system and total delay were a median of 2 days (with Interquartile range IQR of 1−6), 37 days (IQR 13−55), and 38 days (IQR 15−60) respectively. Majority of patients (64/79; 81%) went to private sector (non governmental health care providers) for health care. Number of contacts, which was the most significant, correlate with system delay. Conclusions: Sensitizing the private sector practitioners about cancer in symptomatic children (pallor, bleeding, fever) may be effective.

Keywords

Childhood cancer - epidemiology - patient delay - referral delay


Publication History

Article published online:
16 August 2021

© 2011. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Available from: http://www.icmr.nic.in/ncrp/bcifuture.pdf [last cited 2010 Jan 1].
  • 2 Pui CH, Schrappe M, Masera G, Nachman J, Gadner H, Eden OB, et al. Ponte di Legno Working Group: Statement on the right of children with leukemia to have full access to essential treatment and report on the Sixth International Childhood Acute Lymphoblastic Leukemia Workshop. Leukemia 2004;18:1043-53.
  • 3 Arceci R, Ettinger A, Forman E, Haase GM, Hammond GD, Hoffman R, et al. National action plan for childhood cancer: Report of the national summit meetings on childhood cancer. CA Cancer J Clin 2002;52:377-9.
  • 4 Pui CH, Cheng C, Leung W, Rai SN, Rivera GK, Sandlund JT, et al. Extended follow-up of longterm survivors of childhood acute lymphoblastic leukemia. N Engl J Med 2003;349:640-9.
  • 5 Ribeiro RC, Pui CH. Saving the children - improving childhood cancer treatment in developing countries. N Engl J Med 2005;352:2158-60.
  • 6 Reaman GH. A national approach to evaluating delays in diagnosis and treatment: Potential implications for age related and geo-political differences in access to care and outcome in children and adolescents with cancer. Pediatr Blood Cancer 2008;51:447-8.
  • 7 Koivunen P, Rantala N, Hyrynkangas K, Jokinen K, Alho OP. The impact of patient and professional diagnostic delays on survival in pharyngeal cancer. Cancer 2001;92:2885-91.
  • 8 Kowalski LP, Carvalho AL. Influence of time delay and clinical staging in the prognosis of head and neck cancer. Oral Oncol 2001;37:94-8.
  • 9 de Camargo B, de Andrea ML, Franco EL. Catching up with history: Treatment of Wilms′ tumour in a developing country. Med Pediatr Oncol 1987;15:270-6.
  • 10 Saha V, Love S, Eden T, Micallef-Eynaud P, MacKinlay G. Determinants of symptom interval in childhood cancer. Arch Dis Child 1993;68:771-4.
  • 11 Mehta V, Chapman A, McNeely PD, Walling S, Howes WJ. Latency between symptom onset and diagnosis of pediatric brain tumours: An Eastern Canadian geographic study. Neurosurgery 2002;51:365-72.
  • 12 Klein-Geltink JE, Pogany LM, Barr RD, Greenberg ML, Mery LS. Waiting times for cancer care in Canadian children: Impact of distance, clinical, and demographic factors. Pediatr Blood Cancer 2005;44:318-27.
  • 13 Dang-Tan T, Trottier H, Mery LS, Morrison HI, Barr RD, Greenberg ML, et al. Delays in diagnosis and treatment among children and adolescents with cancer in Canada. Pediatr Blood Cancer 2008;51:468-74.
  • 14 Advani S, Pai S, Venzon D, Adde M, Kurkure PK, Nair CN, et al. Acute lymphoblastic leukemia in India: An analysis of prognostic factors using a single treatment regimen. Ann Oncol 1999;10:167-76.
  • 15 Ribeiro RC, Steliarova-Foucher E, Magrath I, Lemerle J, Eden T, Forget C, et al. Baseline status of paediatric oncology care in ten low-income or mid-income countries receiving My Child Matters support: A descriptive study. Lancet Oncol 2008;9:721-9.