Abstract Background and Objectives Primary central nervous system (CNS) tumors are the second leading cause of childhood cancer in Peru. Delays in recognizing symptoms can affect the time needed to diagnose and provide specialized care. The study aimed to measure the time intervals for diagnosis and the referral pathways for patients diagnosed with CNS from the National Institute of Neoplastic Diseases (INEN). Methods Between September 2023 and April 2024, information on time intervals was prospectively collected for newly diagnosed patients with CNS tumors aged 0–18 years referred to INEN. Results 74 cases were evaluated, with a median age of 9 years (IQR 6-12 years, range 2-18 years). Thirty-eight (51.4%) were male. The most common initial symptoms were headache (n = 34 44.7%) and vomiting (n = 7, 9.2%). Primary care physicians (n = 26, 34.2%) and pediatricians (n = 25, 32.9%) were consulted, with a median of 3 symptoms (IQR 2.5–4, range 1–7) and were seen by an average of 4 professionals (IQR 3–5, range 1–9) before diagnosis. Computed tomography (n = 53, 69.7%) was the most frequently used imaging, followed by magnetic resonance imaging (n = 23, 30.2%). From the first consultation to diagnostic imaging, 32 days (IQR 10–71, range 0–722); from diagnostic imaging to tumor resection, 8 days (IQR 3–20, range 0–338 days); and from resection to arrival at INEN, 28 days (IQR 16–47, range 7–175 days). Most cases were supratentorial (n = 41, 53.9%), cerebellum (n = 17, 22.3%), and brainstem (n = 10, 13.2%). The most common histological types identified were low-grade glioma (n = 12, 15.8%), high-grade glioma (n = 11, 14.5%), medulloblastomas (n = 11, 14.5%), and sarcomas (n = 10, 13.2%). Conclusions Diagnostic time intervals are variable; however, the most significant delay is found within the health system. Studying the factors that cause these delays would help improve the early initiation of treatment and the survival of children and adolescents with CNS tumors who attend INEN.
Díaz-Coronado et al. (Fri,) studied this question.