Mots clés : Cancer, Maroc, retard diagnostique, délai thérapeutique.
Résumé : Background: Early diagnosis is fundamental in pediatric oncology because it allows for timely treatment of the disease in its earliest stages. A few studies have assessed factors associated with cancer latency to diagnosis in children in Africa. To the best of our knowledge this is the first in Morocco.
Methods: We performed a prospective study of 65 cases of childhood cancer referred to the Pediatric Hematology and Oncology department of Rabat Children’s Hospital between January 2017 and April 2017. patients’ data were recorded through interviews with the parents and review of the medical records. We studied the time intervals between onset and final diagnosis and start of treatment and investigated associated factors with shorter intervals.
Results: The median latency to diagnosis in our study was 34 days. The median physician interval was higher than median patient interval (24 vs. 5 days); Gender, family size, residence and type of health insurance had no significant association with latency to diagnosis. There was no significant association between physician lag time and tumor type or health care system variables such as first attending doctor and type of health facility. Misdiagnosis was recorded in 35% of our patients, 8 of them had steroid intake prior to diagnosis of cancer.
Factors associated with a significantly shorter patient interval were mother’s high level of education, age at presentation (patients aged between 5 and 10 years) and parents’ employment (both parents working).
Our findings show that the index of suspicion for childhood cancers remains low in our country and mother’s education level was a factor of shorter consultation delay.Thus, increase in public awareness and continued medical education for general practitioner and pediatricians would reduce latency to pediatric cancer diagnosis in our country.
Auteur : De Laila ESSABAR
Encadrant : Pr Laila HESSISSEN
Date : Octobre 2017