title: Factors associated with the latency to diagnosis of childhood cancer in Peru.
abstract: The latency to diagnosis is the time between the detection of a patient's first symptoms and the cancer diagnosis. The aim of this study was to identify the latency to the diagnosis of cancer in children in Peru and the clinical and sociodemographic factors associated with this latency.
  
  
  
  All patients diagnosed with lymphoma and solid tumors between 2012 and 2014 at a social security referral hospital in Peru were retrospectively evaluated. Clinical and demographic variables were analyzed to assess their association with the latency to diagnosis.
  
  
  
  A total of 284 patients younger than 18 years of age were included in the study. The median time to diagnosis was 8.8 weeks, with a median patient interval of 2 weeks and diagnostic interval of 4.4 weeks. We found significant differences in the latency to diagnosis for different types of cancer (longer for Hodgkin lymphoma and shorter for Wilms tumor). Older children had significantly longer latencies to diagnosis (P = 0.048; OR: 1.05, 95% CI [1.0-1.1]), as did children who were first diagnosed by a general physician rather than by a pediatrician or surgeon (P = 0.028; OR: 2.1, 95% CI [1.1-4.2]). Parental age, level of education, marital status, metastatic disease, clinical stage, and gender did not significantly affect latency to diagnosis as analyzed by a multivariate analysis.
  
  
  
  In Peru, median latency to diagnosis was comparable to that described in developing countries, where the index of suspicion for childhood cancer remains low. It is crucial to establish strategies to optimize early diagnoses using associated factors.
authors.affiliation: Pediatric Oncology Unit, Department of Oncology, Edgardo Rebagliati Martins Hospital, Lima, Peru. lilianavasq@gmail.com.
authors.forename: Liliana
authors.initials: L
authors.lastname: Vasquez
authors.affiliation: Pediatric Oncology Unit, Department of Oncology, Edgardo Rebagliati Martins Hospital, Lima, Peru.
authors.forename: Monica
authors.initials: M
authors.lastname: Oscanoa
authors.affiliation: Pediatric Oncology Unit, Department of Oncology, Edgardo Rebagliati Martins Hospital, Lima, Peru.
authors.forename: Mariela
authors.initials: M
authors.lastname: Tello
authors.affiliation: Department of Epidemiology, Health Technology and Research Institute (IETSI - ESSALUD), Lima, Peru.
authors.forename: Elena
authors.initials: E
authors.lastname: Tapia
authors.affiliation: Pediatric Oncology Unit, Department of Oncology, Edgardo Rebagliati Martins Hospital, Lima, Peru.
authors.forename: Ivan
authors.initials: I
authors.lastname: Maza
authors.affiliation: Pediatric Oncology Unit, Department of Oncology, Edgardo Rebagliati Martins Hospital, Lima, Peru.
authors.forename: Jenny
authors.initials: J
authors.lastname: Geronimo
mesh_terms: D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D057210:Delayed Diagnosis; D005260:Female; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D009369:Neoplasms / Q000175:diagnosis* / Q000473:pathology; D010290:Parents; D012189:Retrospective Studies
keywords: childhood cancer; lag time; latency to diagnosis