title: Factors influencing time to diagnosis of childhood cancer in Ibadan, Nigeria.
abstract: BACKGROUND
  Early diagnosis of cancer allows an opportunity for timely treatment while disease burden is in its earliest stages. Unfortunately, late presentation and delayed diagnosis of childhood cancers remains a problem in developing countries.
  
  
  OBJECTIVE
  To describe the pre-diagnostic symptomatic intervals and the factors influencing these time intervals in childhood cancer at the University College Hospital, Ibadan, Nigeria.
  
  
  METHODS
  Information was obtained from the case notes of children seen between March 2006 and August 2008. Information included socio-demographic variables, stage of the cancer, duration of illness at diagnosis and other health seeking activities.
  
  
  RESULTS
  Sixty-four children (40 males, 24 females) were studied. Median overall lag time was 13.1 weeks; median parent delay was 2 weeks and median health system delay was 8.8 weeks. Median lag times were shortest in acute leukaemia (8.1 weeks) and Wilms. tumour (8.7 weeks) and longest in Hodgkin lymphoma (101.7 weeks).
  
  
  CONCLUSIONS
  Lag times were longer than those in developed countries. Factors contributing to delayed diagnosis included delayed referral by doctors, seeking health care from alternate sources and financial constraints. Education of parents and physicians on early presentation and early referral for early diagnosis is recommended.
authors.affiliation: Department of Paediatrics, College of Medicine, University of Ibadan. bawojames@yahoo.com
authors.forename: B J
authors.initials: BJ
authors.lastname: Brown
authors.forename: B O
authors.initials: BO
authors.lastname: James
authors.forename: S O
authors.initials: SO
authors.lastname: Ajayi
authors.forename: O A
authors.initials: OA
authors.lastname: Ogun
authors.forename: R E
authors.initials: RE
authors.lastname: Oladokun
mesh_terms: D000293:Adolescent; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D057210:Delayed Diagnosis; D005260:Female; D006297:Health Services Accessibility; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D008297:Male; D009367:Neoplasm Staging; D009369:Neoplasms / Q000145:classification / Q000175:diagnosis*; D009549:Nigeria; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012307:Risk Factors; D018426:SEER Program / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D013997:Time Factors