title: Brain tumor signs and symptoms: analysis of primary health care records from the UKCCS.
abstract: OBJECTIVE
  To compare the frequency of brain tumor signs and symptoms in children with and without brain tumors.
  
  
  METHODS
  This was a UK population-based retrospective analysis of primary care records. Participants were 195 children (1-14 years) newly diagnosed with brain tumors and 285 controls matched by age, gender, and region. Comparisons included total number of prediagnosis consultations, number with >or=1 symptom suggestive of a brain tumor, total number of symptoms, number of different symptoms, and number of visits with specific combinations of symptoms.
  
  
  RESULTS
  On average, cases consulted more often than controls between birth and diagnosis/pseudodiagnosis with brain tumor signs and symptoms. Their consultation rate with >or=1 suggestive symptom escalated in the 2 years before diagnosis. Symptom prevalence was higher among cases than controls, a relative difference of 3.29 times as many consultations with >or=1 suggestive symptom (95% confidence interval [CI]: 2.82-3.83) and 7.01 as many with more than 1 (95% CI: 5.38-9.13). In each 6-month period in the 4 years before diagnosis, cases had at least twice as many consultations with >or=1 suggestive symptom (20.81 times as many in the 6 months before diagnosis [95% CI: 14.29-30.30]) and 2-3 times more records of suggestive symptoms (28.35 times more in the 6 months before diagnosis [95% CI: 19.05-42.19]). Symptoms rarely or not observed among control children included head tilt, odd head movements, odd posture, back or neck stiffness, and unsteadiness without obvious cause. CONCLUSION Key to identifying the 1 child among many who merits prompt investigation is recognition of unusual symptoms, or specific symptom patterns.
authors.affiliation: Department of Health Sciences, University of York, York, United Kingdom. pat.ansell@egu.york.ac.uk
authors.forename: Pat
authors.initials: P
authors.lastname: Ansell
authors.forename: Tom
authors.initials: T
authors.lastname: Johnston
authors.forename: Jill
authors.initials: J
authors.lastname: Simpson
authors.forename: Simon
authors.initials: S
authors.lastname: Crouch
authors.forename: Eve
authors.initials: E
authors.lastname: Roman
authors.forename: Susan
authors.initials: S
authors.lastname: Picton
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D016001:Confidence Intervals; D003955:Diagnostic Tests, Routine; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008487:Medical History Taking; D008499:Medical Records; D016017:Odds Ratio; D010808:Physical Examination; D011320:Primary Health Care / Q000592:standards* / Q000639:trends; D012017:Referral and Consultation / Q000639:trends; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D006113:United Kingdom / Q000453:epidemiology