Department of Pediatric Oncology, Adnan Menderes University School of Medicine, Aydin, Turkey.
Pediatr Blood Cancer. 2011 Sep;57(3):392-7. doi: 10.1002/pbc.23072. Epub 2011 Mar 7.
There are few reports from developing countries on the factors that influence the time to diagnosis (TD) in childhood cancer. The purpose of this study was to investigate the determinants of the TD in Turkish cancer patients.
A retrospective analysis was performed on 329 children diagnosed with cancer, excluding leukemia. The TD, including parent/patient time and physician time, was defined as the interval between the onset of symptoms and the final diagnosis.
The median times for parent/patient, physician, and TD were 3, 28, and 53 days, respectively. For patient in the 1-9 years age group, physician time and TD were significantly shorter than in infants and those over 10 years. The longest median TD was recorded for children with germ cell tumors and retinoblastoma; the shortest was in children with renal tumors. When the first point of contact was a pediatrician, a private hospital or physician's office, a governmental educational hospital or a university hospital physician time was short. The longest TD was noted in patients who first contacted a non-pediatric specialist. The most significant predictors of parent/patient, physician time, and TD were metastases at diagnosis, first medical center, and first health professional contacted, respectively.
The TD for childhood lymphomas and solid tumors was related to patient age, tumor type and location, the presence of distance metastases, first health professional, and center contacted. All physicians, especially other specialists seeing pediatric patients, need to be further sensitized to the signs and symptoms of childhood cancer.
发展中国家关于影响儿童癌症诊断时间（TD）的因素的报告很少。本研究的目的是调查土耳其癌症患者 TD 的决定因素。
对 329 名非白血病儿童癌症患者进行回顾性分析。TD 包括家长/患者时间和医生时间，定义为症状发作和最终诊断之间的间隔。
家长/患者、医生和 TD 的中位数时间分别为 3、28 和 53 天。1-9 岁年龄组的患儿，医生时间和 TD 明显短于婴儿和 10 岁以上患儿。生殖细胞肿瘤和视网膜母细胞瘤患儿的中位 TD 最长；肾肿瘤患儿最短。当第一接触点是儿科医生、私立医院或医生办公室、政府教育医院或大学医院时，医生时间较短。在首次接触非儿科专家的患者中，TD 最长。家长/患者时间、医生时间和 TD 的最重要预测因素分别是诊断时的转移、第一医疗中心和首次接触的卫生专业人员。
儿童淋巴瘤和实体瘤的 TD 与患者年龄、肿瘤类型和位置、远处转移的存在、首次接触的卫生专业人员和就诊中心有关。所有医生，尤其是其他看儿科患者的专家，都需要进一步提高对儿童癌症的症状和体征的认识。
