Clinical and social factors that affect the time to diagnosis of Mexican children with cancer.
BACKGROUND
There are few studies on the factors that influence the time to diagnosis (TD) in childhood cancer. The object of the present study was to determine the influence of some clinical and social factors associated to TD in children with cancer seen at Mexico City (MC) hospitals.


METHODS
A retrospective study was performed. A total of 4,940 clinical records of children with cancer were reviewed. Cases of cancer were grouped, according to the International Classification of Childhood Cancer. The median (med) TD was calculated for each group (type) of cancer. The association between delayed TD (longer than 1 month) and type, age at diagnosis, parental educational level, medical institution, and place of residence was analyzed, for which the odds ratio (OR) and 95% confidence intervals (CI) were obtained.


RESULTS
Leukemias had the shortest TD (med = 1 month), while Hodgkin disease (HD) and retinoblastoma had the longest TD (med = 5 months). The highest risk for delayed TD was in children with HD (OR = 7.0; 95% CI 5.3-9.3), in the 10-14 age group (OR = 1.8; 95% CI 1.4-2.3), with low maternal educational level (OR = 1.5; 95% CI 1.2-2.1), in the population with no access to social security (OR = 1.3; 95% CI 1.1-1.4), and whose place of residence is far from MC (OR = 1.5; 95% CI 1.2-2.1).


CONCLUSIONS
In Mexican children with cancer, age at diagnosis, and societal characteristics are important factors affecting timely diagnosis.
Unidad de Investigación Médica en Epidemiología Clínica, Hospital de Pediatría, Centro Medico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Mexico. afajardo@servidor.unam.mx
Arturo
A
Fajardo-Gutiérrez
Aidé María
AM
Sandoval-Mex
Juan Manuel
JM
Mejía-Aranguré
Mario Enrique
ME
Rendón-Macías
María del Carmen
Mdel C
Martínez-García
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D016001:Confidence Intervals; D003937:Diagnosis, Differential; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D008297:Male; D008499:Medical Records; D008800:Mexico / Q000453:epidemiology; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D016017:Odds Ratio; D010819:Physician's Role; D010818:Practice Patterns, Physicians'; D011787:Quality of Health Care; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013997:Time Factors