Academic Unit of Population and Lifespan Sciences, University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, UK
Academic Unit of Population and Lifespan Sciences, University of Nottingham Faculty of Medicine and Health Sciences, Nottingham, UK.
BMJ Open. 2022 Feb 16;12(2):e058744. doi: 10.1136/bmjopen-2021-058744.
Childhood cancer is diagnosed in 400 000 children and young people (CYP) aged 0-19 years worldwide annually. In the UK, a child's cumulative cancer risk increases from 1 in 4690 from birth to aged 1, to 1 in 470 by age 15. Once diagnosed, access to treatments offers survival to adulthood for over 80%. Tumour diagnoses are at a later stage and mortality is higher when compared with those in other parts of Europe. This means higher risk, more intensive therapies for a cure. Some CYPs are known to experience delays to diagnosis which may further contribute to poor outcomes. This study aims to understand the current pathway of childhood cancer referrals and diagnosis and quantify diagnostic intervals in the UK.
This is a prospective multicentre observational study including all tertiary childhood cancer treatment centres in the UK. CYP (0-18 years) with a new diagnosis of cancer over the study period will be invited to participate. Data will be collected at initial diagnosis and 5 years after diagnosis. Data will include demographic details, clinical symptoms, tumour location, stage and clinical risk group. In addition, key diagnostic dates and referral routes will be collected to calculate the diagnostic intervals. At 5 years' follow-up, data will be collected on refractory disease, relapse and 1-year and 5-year survival. Population characteristics will be presented with descriptive analyses with further analyses stratified by age, geographical region and cancer type. Associations between diagnostic intervals/delay and risk factors will be explored using multiple regression and logistic regression.
The study has favourable opinion from the York and Humber, Leeds West REC (19/YH/0416).
Results will be presented at academic conferences, published in peer-reviewed journals and disseminated through public messaging in collaboration with our charity partners through a national awareness campaign (ChildCancerSmart).
researchregistry.com (researchregistry5313).
全球每年有 40 万名 0-19 岁的儿童和青少年（CYP）被诊断患有癌症。在英国，儿童的癌症累积风险从出生到 1 岁时的 1/4690 增加到 15 岁时的 1/470。一旦被诊断出患有癌症，接受治疗后超过 80%的儿童能够存活到成年。与欧洲其他地区相比，英国的肿瘤诊断较晚，死亡率更高。这意味着需要更高的风险、更密集的治疗方法来治愈。一些 CYP 被发现存在诊断延迟的情况，这可能会进一步导致不良结局。本研究旨在了解英国儿童癌症转诊和诊断的现状，并量化英国的诊断间隔时间。
这是一项前瞻性多中心观察性研究，包括英国所有三级儿童癌症治疗中心。在研究期间，将邀请新诊断患有癌症的 CYP（0-18 岁）参与研究。将在初始诊断和诊断后 5 年收集数据。数据将包括人口统计学细节、临床症状、肿瘤位置、分期和临床风险组。此外，还将收集关键诊断日期和转诊途径，以计算诊断间隔时间。在 5 年随访时，将收集难治性疾病、复发以及 1 年和 5 年生存率的数据。将使用描述性分析呈现人口特征，并进一步按年龄、地理位置和癌症类型进行分层分析。将使用多元回归和逻辑回归探索诊断间隔/延迟与危险因素之间的关联。
该研究得到了约克和亨伯、利兹西部 REC（19/YH/0416）的赞成意见。
研究结果将在学术会议上进行汇报，发表在同行评议期刊上，并通过与慈善合作伙伴合作的全国宣传活动（ChildCancerSmart）以大众信息的形式进行传播。
研究在 researchregistry.com 注册（researchregistry5313）。
