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
