Symptom interval in pediatric patients with solid tumors: Adolescents are at greater risk of late diagnosis†

Background The awareness that adolescents can have cancer is probably insufficient, not only among teenagers and their families, but also among physicians, and adolescent patients are reportedly often referred to qualified cancer institutes after a considerable delay. Procedure A prospective series of 425 patients (28% of them adolescents) with solid tumors was analyzed to investigate the correlation between symptom interval and age, and the different contributions to symptom interval in terms of the time from symptom onset to the first contact with a doctor (patient delay), referral to the oncologist (referral delay), and final diagnosis (oncologist delay). Results The median symptom interval was 47 days for 0 to 14-year-old patients and 137 for those ≥15 years (P < 0.001). The greatest delay in the adolescent group related to the patient delay (63.3% of the total symptom interval). Conclusion Adolescents are often diagnosed with longer delay as compared to children. The main contribution to symptom interval in adolescents appears to be due to the time they first go to a doctor; however, also the time taken by the physician to the patient to a specialist (oncologist or surgeon) able to define the diagnosis of cancer was longer for adolescents than for younger patients. Pediatr Blood Cancer 2013; 60: 605–610. © 2012 Wiley Periodicals, Inc.