Impact of an education program on late diagnosis of retinoblastoma in Honduras.
BACKGROUND
In developed countries, more than 90% of children with retinoblastoma present with limited-stage disease and are cured; however, in countries with limited resources, like Honduras, most patients present with advanced disease and cure rates are less than 50%. Early diagnosis is necessary to improve the survival of children with retinoblastoma in these countries.


METHODS
We describe the preliminary results of a retinoblastoma education program linked to a national vaccination campaign in Honduras. Posters and flyers were designed to be accessible to poorly educated readers, to convey the severity of retinoblastoma, and to provide contact information. Charts and an electronic database were reviewed to determine age at diagnosis, presenting signs and symptoms, date of diagnosis, and outcome.


RESULTS
During the eight previous years (July 1995-June 2003), 73% of the 59 diagnosed cases of retinoblastoma were extraocular; in contrast, during the post-campaign period (June 2003-January 2005), only 35% of the 23 diagnosed cases showed extraocular spread (P = 0.002). More than one-third of patients in both time periods either refused therapy or abandoned treatment.


CONCLUSIONS
This inexpensive approach is an effective first step toward improving survival of childhood retinoblastoma. Abandonment and refusal of therapy are continuing obstacles.
Leander
Christopher
C
Weill Cornell Medical College, New York, New York, USA.
Fu
Ligia C
LC
Peña
Armando
A
Howard
Scott C
SC
Rodriguez-Galindo
Carlos
C
Wilimas
Judith A
JA
Ribeiro
Raul C
RC
Haik
Barrett
B
D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D003937:Diagnosis, Differential; D018572:Disease-Free Survival; D004502:Education, Medical, Continuing / Q000191:economics; D005134:Eye Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000401:mortality / Q000628:therapy; D005260:Female; D006721:Honduras; D006801:Humans; D008297:Male; D012175:Retinoblastoma / Q000175:diagnosis* / Q000191:economics / Q000401:mortality / Q000628:therapy; D012189:Retrospective Studies; D015996:Survival Rate; D014611:Vaccination