title: Delay in the diagnosis of retinoblastoma in China.
abstract: OBJECTIVE
  Retinoblastoma is the most frequent primary intraocular tumour and is rapidly gaining importance in Asia. As the survival is markedly dependent on early diagnosis and as information on that is not available from East Asia, we assessed the time interval between symptoms detection and therapy of children treated in the Beijing TongRen Eye Hospital.
  
  
  METHODS
  The retrospective study consisted of all patients who were treated in the study period from January 1987 to November 2006 in the Beijing TongRen Hospital and for whom the data on delay in diagnosis, age, clinical appearance and histological tumour features were available.
  
  
  RESULTS
  The inclusion criteria were met by 572 patients (326 boys) with a mean age of 2.6 ± 1.8. Mean interval between first detection of symptoms and clinical diagnosis and therapy was 4.1 ± 5.9 months (range: 3-36 months). A diagnostic delay of 2 months or >6 months was found for 337 (59%) children and 98 (17%) children, respectively. Diagnostic delay was significantly (p < 0.001) the longest in the 2- to 4-year-old group (5.5 ± 7.4 months). It decreased from the study period 1987-1991 to the period 2002-2006 (p < 0.001). It was significantly associated with the clinical appearance (p = 0.001) and histological finding (p = 0.008).
  
  
  CONCLUSIONS
  Delay in the diagnosis of retinoblastoma depended on the age of the children, study period, and clinical and histological stage. Because the prognosis is markedly influenced by tumour stage, further improvements in the alertness of parents, family doctors and paediatricians and in the medical infrastructure in China may be addressed.
authors.affiliation: Beijing Institute of Ophthalmology, Beijing TongRen Hospital, Capital Medical University, China.
authors.forename: Shuwei
authors.initials: S
authors.lastname: Bai
authors.forename: Ruojin
authors.initials: R
authors.lastname: Ren
authors.forename: Bin
authors.initials: B
authors.lastname: Li
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Xu
authors.forename: Bowen
authors.initials: B
authors.lastname: Zhao
authors.forename: Fei
authors.initials: F
authors.lastname: Gao
authors.forename: Liaoqing
authors.initials: L
authors.lastname: Li
authors.forename: Jost B
authors.initials: JB
authors.lastname: Jonas
mesh_terms: D044466:Asian People; D002675:Child, Preschool; D002681:China; D057210:Delayed Diagnosis; D005260:Female; D006801:Humans; D008297:Male; D019572:Retinal Neoplasms / Q000145:classification / Q000175:diagnosis*; D012175:Retinoblastoma / Q000145:classification / Q000175:diagnosis*; D012189:Retrospective Studies; D013997:Time Factors