Presentation of childhood cancers to a paediatric shared care unit

Abstract

The majority of children diagnosed with cancer present via acute services, with the route varying between tumour types. Only two cases in 10 years were referred via the 2-week pathway, thus challenging its relevance in the paediatric population.

Specific and Non-specific Clinical Presentations in the Year Before the Diagnosis of Childhood Leukaemia

“…Compared to previous case-only studies [9][10][11] in which confounding by time-related factors such as age or season cannot be ruled out, we were able to demonstrate relative rates of presentations compared to both case baseline and matched controls. The stable rates of healthcare access over time in the matched controls suggested that our estimates were unlikely to be largely confounded by time-related factors.…”

“…corresponding numbers are listed in Supplementary Appendix I (pp. [6][7][8][9][10][11]. Among the six general presentations examined, rates of haematological presentations, musculoskeletal presentations, and injuries were the earliest to increase significantly compared to controls, which were found to increase since the third month (61-90 days) before the date of lymphoid leukaemia diagnosis ( Fig.…”

“…Clinical studies have reported some presentations before or at the time of leukaemia diagnosis, such as fever, anaemia, bleeding or musculoskeletal discomfort . Researchers have also attempted to summarise the duration between initial presentations and leukaemia diagnosis in case series . However, many of these presentations are not specific and can be seen among children with leukaemia as well as children in the general population, and the extent to which these presentations were associated with leukaemia is unclear.…”

“…[1][2][3][4][5][6][7][8] Researchers have also attempted to summarise the duration between initial presentations and leukaemia diagnosis in case series. [9][10][11] However, many of these presentations are not specific and can be seen among children with leukaemia as well as children in the general population, and the extent to which these presentations were associated with leukaemia is unclear.…”

Association of Self-reported Presenting Symptoms With Timeliness of Help-Seeking Among Adolescents and Young Adults With Cancer in the BRIGHTLIGHT Study

“…Literature on the nature and frequency of symptoms experienced by adolescents and young adults before cancer diagnosis is sparse; study populations often exclude those older than 16 years. 20 , 25 , 26 Most existing studies 6 , 19 , 27 on adolescents and young adults are based on information captured in EHRs. In comparison, our findings based on self-reported data indicate substantially higher frequencies of presenting symptoms among adolescent and young adults before cancer diagnosis.…”