title: Evaluation of delays in diagnosis and treatment of childhood malignancies in Bangladesh.
abstract: BACKGROUND
  Malignancy is one of the leading causes of morbidity and mortality worldwide. According to GLOBOCAN 2012, an estimated 14.1 million new cancer cases and 8.2 million cancer-related deaths occurred in 2012. It is estimated that childhood malignancies are 0.5-4.6% of total malignancies. However, from the point of view of potential year lost due to childhood malignancies, it is more important than adult.
  
  
  METHODS
  To find out the probable components for the delay in diagnosis and treatment of childhood malignancies in Bangladesh, cross-sectional observational study was done at the National Institute of Cancer Research and Hospital, Dhaka, Bangladesh, from January 2014 to June 2014.
  
  
  RESULTS
  A total of 171 patients were included in the study. They were divided into four age groups. The mean age was 8.422 years with standard deviation ± 5.381 years and their age ranged from 2 months to 18 years. In aggregate, about 70% of the cases had to wait for more than 90 days for the treatment. About 15% had to wait for 31-60 days. Negligible percentage of patients got treatment before 30 days. Among the three components of delay, patients delay was influenced by age of the child, economic status of the family, parental education, and awareness of the parents about malignancy.
  
  
  CONCLUSIONS
  More than one-third of the pediatric patients had to wait three months or more for treatment to start for various reasons. By raising awareness among the stake holders this problem can be minimized. Further studies are recommended to explore the other factors which might cause delayed referral.
authors.affiliation: Department of Paediatric Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh.
authors.forename: Mamtaz
authors.initials: M
authors.lastname: Begum
authors.affiliation: Department of Cancer Epidemiology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh.
authors.forename: Md Johirul
authors.initials: MJ
authors.lastname: Islam
authors.affiliation: Department of Radiation Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh.
authors.forename: Md Waheed
authors.initials: MW
authors.lastname: Akhtar
authors.affiliation: Department of Paediatric Oncology, National Institute of Cancer Research and Hospital, Dhaka, Bangladesh.
authors.forename: Sabina
authors.initials: S
authors.lastname: Karim
keywords: Bangladesh; childhood malignancies; delays in diagnosis