Delay and causes of delay in the diagnosis of childhood cancer in Africa
Background: Although a few studies have investigated delays in diagnosis and treatment among children and adolescents with cancer, this has never been subject of study in South Africa. Early diagnosis is fundamental as it allows timely treatment and prevents unnecessary complications. Procedures: Combined prospective and retrospective study of 194 children with cancer at Tygerberg Hospital, Cape Town, diagnosed between 2000 and 2009: 126 patients were included through review of the medical charts and 68 through interviews with the parents. Results: The median total diagnosis delay was 34 days (2-1,826). The median patient delay was 5 days (0-457). The median physician delay was 20 days (0-924). Gender, age or ethnicity of the children, as well as parental level of education did not have a significant influence on the total time to diagnosis. Initial misdiagnoses were frequent (58%). Conclusions: There is considerable delay in diagnosing childhood cancer in the area served by Tygerberg Hospital, due mostly to a physician delay of 20 days on average. The findings of our unit should be correlated with other South African centers. There is a clear need to increase parental awareness of childhood cancer and to intensify the education of nurses and doctors with regard to the warning signs of the disease. © 2010 Wiley-Liss, Inc.