Awareness Of Childhood Cancer Research Articles

Online resources for childhood cancer awareness.

Online resources for childhood cancer awareness.

Childhood Cancer Awareness Program in Bungoma County, Kenya.

Awareness could play a key role in reducing underdiagnosis and accelerating referral of childhood cancer in low- and middle-income countries and ultimately improve outcomes. This study describes the implementation of a childhood cancer awareness program in Bungoma County in Kenya, containing five components: (1) baseline data collection of primary healthcare facilities; (2) live training session for healthcare providers (HCP); (3) early warning signs posters; (4) online SMS course for HCP; and (5) radio campaign. This study was conducted between January and June 2023. All 144 primary healthcare facilities (level 2 and 3 health facilities) within Bungoma County were visited by the field team. All 125 level 2 (87%) and 19 level 3 (13%) facilities participated in the study. National Health Insurance Fund (NHIF) failed to cover services in 37 (26%) facilities. HCP were more often reported absent at level 3 (89%) than level 2 (64%) facilities (P = 0.034). The 144 live training sessions were attended by over 2000 HCP. Distribution of 144 early warning signs posters resulted in 50 phone calls about suspected childhood cancer cases. Sixteen children were later confirmed with childhood cancer and treated. Online SMS learning was completed by 890 HCP. Knowledge mean scores improved between pre-test (7.1) and post-test (8.1; P < 0.001). Finally, 540 radio messages about childhood cancer and a live question-and-answer session were broadcasted. This study described the implementation of a childhood cancer awareness program in Kenya involving both HCP and the general public. The program improved HCP's knowledge and increased the number of referrals for children with cancer.

Type of cancer and complementary and alternative medicine are determinant factors for the patient delay experienced by children with cancer: A study in West Java, Indonesia.

Most pediatric cancer patients in developing countries present at an advanced stage due to delayed diagnosis, being an important barrier to effective care. The objective of this study was to evaluate the associated factor of patient delay and explore significant parental practice-associated risk factor to patient delay. This was a sequential mixed methodology, utilizing data from the Indonesian Pediatric Cancer Registry for clinical variables and completed interviews with parents using structured questionnaires to obtain their sociodemographic data. A binary logistic regression analysis model was fitted to identify factors associated with patient delay. Additional semi-structured interviews related to parental practice of using complementary and alternative medicine (CAM) were administered to 30 parents. Thematic framework analysis was performed on qualitative data to explore determinant factors of parental practice of using CAM. We interviewed 356 parents with children with cancer. The median patient delay was 14days (interquartile range [IQR]: 6-46.5days). The most extended delay was in patients with malignant bone tumors (median 66, IQR: 14-126). In multivariable logistic regression analysis, solid cancer (odds ratio [OR]=5.22, 95% confidence interval [CI]: 2.79-9.77, p<.001) and use of CAM (OR=1.86, 95% CI: 1.13-3.08, p=.015) were associated with patient delay. Qualitative interviews highlighted key issues relative to determinant parental factors using CAM, including vague initial childhood cancer symptoms, parental health-seeking behavior, CAM availability and accessibility, also barriers of healthcare facilities. Type of cancer and use of CAM are essential factors that cause patient delay. It should be addressed in the future childhood cancer awareness and childhood cancer diagnosis pathway.

Developing Interactive Design for Educating Childhood Cancer Awareness

Current websites specific to childhood cancer still lack approachable design. The interface and layout are unattractive with inappropriate and limited multimedia elements, making the information dissemination to the user ineffective. Hence, this study aims to develop an interactive infographic website to educate childhood cancer named i-Hope. The objectives are to identify and implement suitable multimedia and interactive features, integrate them with the appropriate interaction design and approach in producing the website. The methods comprise five phases: analysis, design, development, implementation and evaluation. This paper discusses the development and evaluation of the website in attracting users' interest in childhood cancer.

Development of Culturally Adapted Media to Increase Community Awareness of Childhood Cancer in Tanzania

PURPOSE There is low childhood cancer awareness in many low and middle income countries (LMICs), contributing to delayed hospital presentation, and treatment abandonment. In Tanzania, only 20% of the estimated 3,500 new cases per year present for treatment. While childhood cancer awareness media exist, they are not adapted for use in many LMIC communities, including Tanzania. METHODS To reach consensus on childhood cancer education content and education strategy selection, a Delphi process was completed with an expert advisory panel representing three Tanzanian referral hospitals. Focus groups discussions (FGD) were completed with rural and urban communities from each of the Mwanza, Dar Es Salaam and Kilimanjaro regions. Thematic analysis was guided by content consensus to identify community knowledge gaps. Sample education materials were reviewed to identify preferred delivery format. RESULTS A total of 14 and 72 participants formed the expert panel and community FGD respectively. Education strategies with the highest feasibility and impact included community health worker led education, a song, and social media messaging. The following key knowledge content areas were identified to have the lowest community awareness. (1) The cause of most childhood cancer is unknown: 83% felt untreated illnesses, cooking oil, witchcraft, immune system deficiency, and the environment were causes of childhood cancer; (2) Symptom recognition and hospital based studies can improve early detection: 66% reported that ill children see a traditional healer or pharmacist and only go a hospital if febrile or if symptoms do not improve; (3) Most childhood cancer can be cured with early detection: 50% felt that there is no cure. CONCLUSION This study identified key childhood cancer knowledge gaps within the Tanzanian community and culturally adapted strategies to disseminate education media. Additional studies are needed to evaluate the impact of culturally adapted media on community awareness and early hospital presentation in the region.

Community Awareness About Pediatric Cancer in Tanzania

PURPOSE Early hospital presentation and completion of treatment is crucial for better treatment outcomes in children with cancer. There are thousands of children who die of cancer each year without ever being diagnosed in Tanzania. To address this gap and inform childhood cancer awareness campaigns, it is important to understand the inherent cultural values and beliefs that influence health care seeking behavior among the Tanzanian community. METHODS This was a descriptive qualitative study conducted in Mwanza, Kilimanjaro and Dar- es Salaam regions. Community members aged ≥ 18 years from three rural and three urban communities were purposively selected to participate in seven focus group discussions (each with 8-12 respondents) between March and June 2021. Data were transcribed, coded and analyzed by thematic content-analysis with the support of NVIVO software. RESULTS A total of 72 participants were interviewed. Many had heard of breast or cervical cancer however, awareness of pediatric cancer was low. The belief that cancer in children is caused by witch craft led to initial evaluation by traditional healers leading to delayed presentation to the hospital. Additional community concerns included the cost of transportation and investigations, duration of treatment and community influence on families to abandon hospital treatment for spiritual or traditional treatment. CONCLUSION Low community awareness about pediatric cancer, late hospital presentation and treatment abandonment remains a challenge in most parts of Tanzania. The common belief that childhood cancer is a result of witchcraft and superstition contributes to limited health seeking behavior, especially in the rural areas. Cultural and contextually relevant awareness interventions are needed to increase cancer knowledge and cancer health-seeking behavior in Tanzanian communities.

Evaluation of the awareness of childhood cancers by general practitioners, family physicians and pediatricians

Objective: Although, childhood cancer was considered as a deadly disease in the past, now it is considered as a life-threatening chronic disease if diagnosed early. The present study evaluates how much the symptoms of childhood cancers are recognised by the physicians in Istanbul, Turkey. Materials and Methods: The objective of the study and the questionnaire form was explained to participants and they were asked whether they would like to take part in the study. The questionnaire composed of two sections: 1. Investigated the sociodemographic characteristics of the physicians and 2. Investigated the knowledge of the physicians on childhood cancers (leukaemia, solid tumour, common questions). The physicians were given 2 points for every correct answer; wrong answers and answers such as “I have no idea” were scored 0 points. Based on the correct answers given by all participants, the medians for every question group were calculated. The measure of success was 75 percentile, which was calculated for each question group considering these median values. Results: Examining the percentages of the correct answers to the questions, the best known were the leukaemia questions (74.6%) and the less known were the solid tumour questions (57.1%). The physicians younger than 33 years, which was the mean age, gave better answers to the leukaemia questions and the common questions. When the academic titles of participants were grouped as pediatricians and other physicians, the leukaemia, solid tumour, common group and total points showed statistically high significant differences. Conclusion: Our study has revealed the need of our country for training programs aimed at increasing the awareness of general practitioners working in primary health care institutions, as these institutions are the first reference centers for the pediatric patient population. Childhood cancer awareness must be improved by implementing training programs which in turn will lead to early diagnosis and referral to an appropriate specialist.

Childhood cancer in India

India has made significant improvement in childhood cancer services in last few decades. However, the outcome still remains modest as compared to global standards due to significant barriers in recognition, diagnosis and cure.Data regarding comprehensive childhood cancer burden in country is lacking due to low and urban predominant coverage of population-based cancer registry programs. The available data shows lower incidence of childhood cancer incidence especially in leukaemia and CNS tumours which may suggest poor awareness of caregivers and delayed diagnosis with many “missed cases”. Incidence data are also skewed towards male preponderance which suggests gender bias in seeking healthcare.The childhood cancer services in India are predominantly restricted to few tertiary care centres in major cities. The outcome in major groups of cancer is complicated by delayed and more advanced stage of presentation and poor supportive care during intensive treatment. Treatment refusal and abandonment remains major hurdles.Last few decades saw development of dedicated paediatric oncology services and training programs in the country. The development of InPOG (Indian Paediatric Oncology group) for conducting collaborative trials will lead to adoption of uniform treatment protocols suited for the country. Financial support through the government promoted health insurance and holistic support through philanthropic organizations have improved treatment adherence and outcome.Moving forward, the focus should be on strengthening the cancer registries for capturing nationwide data, improving awareness of childhood cancer among caregivers and healthcare workers for early recognition and improving accessibility of childhood cancer care services beyond major cities.

Using Twitter to raise the profile of childhood cancer awareness month

One of the best-known examples of a campaign to raise awareness about pediatric disease is childhood cancer awareness month (CCAM). This study uses cross-sectional, descriptive-analytical methodology to explore how Twitter was employed during CCAM. We collected childhood cancer-related tweets from August 30 to October 2, 2015, which coincided with CCAM and several days before and after the awareness month. Using MALLET, we applied Latent Dirichlet allocation statistical modeling to extract the main topics of the collected tweets. We then explored how four different types of accounts—organizations, news agencies, celebrities, and individuals—used social media to talk about childhood cancer during CCAM using qualitative content analysis. Our research showed that celebrities were the group whose tweets had the most average impressions. The results also showed that tweets authored by organizations and celebrities were retweeted at greater rates than individuals and even news agencies. This suggests that organizations and celebrities have greater potential to raise awareness about issues like childhood illnesses.

Determinants of delayed diagnosis among pediatric cancer patients from Ayder Comprehensive Specialized Hospital, Mekelle, Northern Ethiopia

BackgroundDespite advances in the field of pediatric oncology, cancer remains a leading cause of death in children. The delays in cancer diagnosis may occur throughout the diagnostic pathway. Diagnosis of childhood cancer as early as possible is crucial to reduce mortality. The aim of this study was to identify determinants of delayed diagnosis among pediatric cancer patients in Ayder Comprehensive Specialized Hospital, Northern Ethiopia.MethodFacility based cross-sectional study was conducted among pediatric cancer patients aged less than 18 years. Data collection was done by interviewer-administered structured questionnaire from the volunteer primary caregiver from 1st September 2017 to 30th August 2018. The data was checked and cleaned by principal investigator on daily basis during data collection for completeness, consistencies, then coded, entered and analyzed using SPSS version 21 software. Diagnosis delay was considered significant when it is above the 3rd quartile. Binary logistic regression analysis was used to test associations between each of the determinant factors and the dependent variable. Variables with P-value < 0.25 during bivariate analysis were fed to the multivariate logistic regression model. Finally, variables with P-value < 0.05 were considered as determinants of delayed diagnosis.ResultsFrom a total of 102 patients, 71(69.6%) had delayed diagnosis. Children older than 10 years of age were four (AOR = 4.01; 95%CI = 1.55–12, P < 0.001) times more likely to get delayed compared to under five children. Rural residence (AOR = 3.3; 95%CI = 1.24–10.24, P < 0.001), uneducated parents (AOR = 3.4; 95%CI = 1.91–13.25, P = 0.009), parents with monthly income less than 1000 ETB (AOR = 6.1; 95%CI = 1.76–7.23, P < 0.001), absence of health insurance (AOR = 2.4; 95%CI = 1.50–3.50, P = 0.02), visit to holy water (AOR = 3.4;95%CI = 1.6–7.2) and those who think cancer is incurable (AOR = 2.7;95%CI = 1.3–14,P = 0.004) were also likely to be delayed.ConclusionDelayed diagnosis of childhood cancer was a major issue and most influenced by the child’s age, residency, family’s socioeconomic status, parental education, health insurance, use of holy water and caregivers perception on curability of cancer. Thus; every effort should be made to promote public and parental awareness of childhood cancer and promoting health insurance.

Brave. Bold. Gold: Athletic Activism and the Realities of Childhood Cancer

ABSTRACT Turn It Gold is both the name of a Houston-based nonprofit and a mandate to rally support for childhood cancer with gold, the color officially chosen to represent childhood cancer awareness. Athletic activism is an important part of their mission, as evidenced by burgeoning partnerships with schools and universities across the country. In this essay, we explore the collective impact of professional and collegiate athletes who use their personal platform for public good. Athletes cannot diminish the grief and loss surrounding childhood cancer. Even so, they can stand in solidarity with impacted families and communities.

Optimizing outcomes for children with non-Hodgkin lymphoma in low- and middle-income countries by early correct diagnosis, reducing toxic death and preventing abandonment.

In high-income countries, more than 90% of children with mature B-cell lymphomas are cured with frontline therapy. However, cure requires prompt and correct diagnosis, careful risk stratification, very intense chemotherapy and meticulous supportive care, together with logistical support for patients who live far from the cancer centre or face financial barriers to receiving care. In low- and middle-income countries (LMIC), cure rates range from 20% to 70% because of lack of diagnosis, misdiagnosis, abandonment of treatment, toxic death and excess relapse with reduced-intensity regimens. Fortunately, a wide range of successful interventions in LMIC have reduced these causes of avoidable treatment failure. Public awareness campaigns have led to societal awareness of childhood cancer; telepathology has improved diagnosis, even in remote areas; subsidized chemotherapy, transportation, housing and food have reduced abandonment; and hand hygiene, nurse training programmes and health system improvements have reduced toxic death. These interventions can be deployed everywhere and at low cost, so are highly scalable. Children and adolescents with Burkitt lymphoma can be cured in all countries by making a timely correct diagnosis, applying protocols adapted to the local context, preventing abandonment of therapy and avoiding toxic death. Reducing these causes of treatment failure is feasible and highly cost-effective everywhere.

The Role of Childhood Cancer Civil Society on Cancer Control on Low-Income Countries

Background and context: Over 250,000 new pediatric cancer cases are diagnosed yearly worldwide. In the developing countries, the childhood cancer burden is estimated to increase even more. Rwanda Children's Cancer Relief (RCCR) is a nonprofit organization with a mission to ensure that children with cancers access high standards of treatment and support. After realizing that majority in our community lack information on childhood cancers, our efforts since 2014 has been concentrated on raising awareness of childhood cancers. Aim: Raise awareness on childhood cancer among community members. Strategy/Tactics: During a massive walk, trained volunteers with informative brochures, posters in both local and international languages comprising information on early symptoms of childhood cancers, ways to navigate referral system among others are used during community outreaches. These activities are aired on national radios and TVs, newspapers and social media are also used to spread information. Program/Policy process: Many activities are carried out in September during the RCCR Annual Childhood Cancers Awareness Month. We involve community health workers, private sectors and academic institutions. We focus on talks, community outreaches and childhood cancers awareness activities. Outcomes: 2017 campaign included the aforementioned activities and was concluded by a walk dubbed (#KidsCancerWalk2016) which attracted more than 600 participants. Two local TVs, 6 radios and 7 online diaries covered the campaign in its different phases. More than 1000 posters, 1100 brochures and 500 flyers were distributed followed by intensive online campaign with more than 100 Facebook posts, 350 Tweets, and 700 Retweets. Strong partnerships with private, public sectors were created and Ministry of Health approved September as the national childhood cancer awareness month following RCCR campaigns. What was learned: Childhood cancers are fatal when left untreated but treatable when they are detected at an early stage. Activities that RCCR carry out on annual basis increase the general population knowledge about childhood cancers. Civil societies like RCCR play a crucial role in addressing the growing burden of childhood cancers and the disparities in access to and quality of care. They can also influence policy changes and address the specific patients' and community needs.

Ana-Vation #FutureInTheirHands: The Power of Innovation, Robotics, and STEAM Education to Raise Awareness of Childhood Cancer in The Emirates

Amount raised: $50,000 (180,000 AED). Background and context: Ana, an Arabic word which means 'I' in English, is a childhood cancer initiative under Friends of Cancer Patients. Ana seeks to raise awareness about the 7 common warning signs of childhood cancer and highlight the importance of early detection, in the United Arab Emirates. In 2018, the Ana initiative launched a 3-year undertaking aimed at using S.T.E.A.M. education to roll out an annual school championship titled “Ana-vation”, a play on words between “Ana” and “innovation”. Ana-vation strategically launched in February during national innovation month, at the Sharjah Center for Astronomy and Space Sciences Planetarium. During the launch, media was invited to observe and 15 participating schools from around the country were briefed on the 4-month championship, electronic components, timeline and expected deliverables. The Ana initiative partnered with a start-up of young engineers to form the Ana-vation team. Students were preselected by their science teachers, to represent their school. Aim: Ana-vation aims to inspire young students to become future researchers, doctors, scientist and engineers, through using innovation and S.T.E.A.M education. The program also offers a bridge to aware parents and teachers, by sending home pamphlets. Strategy/Tactics: Ana-vation is a 4-month campaign (February to May) that rolls out with 15 schools across the Emirates. The program involves the science teacher at each school, who selects 10 students to participate in teams of two (5 teams per school, totaling 75 teams). They have to use the electronic components in the Ana-vation robotic kits and recyclable materials found around their homes, to create a robot to answer in the challenge: “Create an innovative solution to raise awareness about childhood cancer signs and symptoms”. Throughout the 4 months, Ana-vation will conduct workshops at each of the 15 schools to mentor and engage with the students and teach them to code, using basic programing language. Program process: Championship launch - February Training and evaluation roadshows - March Debugging workshops - April Championship and awarding ceremony - May Costs and returns: To cover the cost of the kits + launch event + 15 road show school visits + workshop + award ceremony = $50,000 (180,000 AED) total or $3300 (12,000 AED) per school. FOCP approached corporates to adopt and sponsor a school at $3300. What was learned: Ana-vation was well received by participating schools and sponsoring corporates. It received high media coverage on TV interviews and print media. Offered corporates CSR opportunities, publically associate with a good cause and offered employees volunteer opportunities, plus chance to mentor and engage with young students. FOCP partnered with Manipal University film students and faculty to produce a short documentary on Ana-vation, to be submitted to the Sharjah Children Film Festival in September, to further highlight awareness.

Assessing the feasibility and validity of the Toronto Childhood Cancer Stage Guidelines: a population-based registry study

Cancer stage at diagnosis is crucial for assessing global efforts to increase awareness of childhood cancer and improve outcomes. However, consistent information on childhood cancer stage is absent from population cancer registries worldwide. The Toronto Childhood Cancer Stage Guidelines, compiled through an international consensus process, were designed to provide a standard framework for collection of information on stage at diagnosis of childhood cancers. We aimed to assess the feasibility of implementing the Toronto Guidelines within a national population cancer registry. We did a population-based registry study using data from the Australian Childhood Cancer Registry and included data from children aged 0-14 years diagnosed between Jan 1, 2006, and Dec 31, 2010 with one of 16 childhood cancers listed in the Toronto Guidelines (acute lymphoblastic leukaemia, acute myeloid leukaemia, Hodgkin's lymphoma, non-Hodgkin lymphoma, neuroblastoma, Wilms' tumour, rhabdomyosarcoma, non-rhabdomyosarcoma soft tissue sarcoma, osteosarcoma, Ewing's sarcoma, retinoblastoma, hepatoblastoma, testicular cancer, ovarian cancer, medulloblastoma, and ependymoma). We extracted data from medical records, and assigned stage according to the Tier 1 criteria (basic) and Tier 2 criteria (more detailed, requiring data from cytology, imaging, and other diagnostic tests, where available) using computer algorithms derived from the Toronto Guidelines. Additionally, expert reviewers independently assigned Tier 2 stage to a random subsample of 160 cases (ten per malignancy type). Feasibility of the guidelines was assessed on the percentage of cases that could be staged, agreement between stage assigned by the algorithms and the expert reviewers, and the mean time (min) taken to collect the required data. We obtained data for 1412 eligible children. Stage could be assigned according to Tier 2 criteria for 1318 (93%) cases, ranging from 48 (84%) of 57 cases of non-rhabdomyosarcoma soft tissue sarcoma to 46 (100%) cases of hepatoblastoma. According to Tier 1 criteria, stage could be assigned for 1329 (94%) cases, ranging from 131 (87%) of 151 cases of acute myeloid leukaemia to 46 (100%) cases of hepatoblastoma. By contrast, stage at diagnosis was recorded by the treating physician for 555 (39%) of the 1412 cases. The computer algorithm assigned the same stage as did one or more independent expert reviewers in 155 (97%) of the 160 cases assessed. The mean time taken to review medical records and extract the required data was 18·0 min (SD 9·5 per case). The Toronto Guidelines provide a highly functional framework that can be used to assign cancer stage at diagnosis using data routinely available in medical records for most childhood cancers. Data on staging have the potential to inform interventions targeting improved diagnosis and survival. Cancer Australia.

Announcement: Childhood Cancer Awareness Month — September 2017

<i>Announcement</i>: Childhood Cancer Awareness Month — September 2017

Knowledge, attitude, and awareness of childhood cancer among undergraduate medical students in South India.

Background:In India roughly 60000 childhood cancer cases are diagnosed annually with only nearly 100 pediatric oncologists. So it's pertinent that the physicians and pediatricians are adequately equipped to recognize and refer them appropriately. Hence this study was conducted to assess the knowledge, attitude and awareness of childhood cancer among undergraduate medical students in South India.Materials and Methods:The study was conducted among 240 undergraduate students from all over South India in a undergraduate pediatric clinical training. A 24 point questionnaire was given to assess their understanding of pediatric malignancies and their interest towards pediatric oncology. Statistical analysis was done with SPSS 18.V software.Results:50% were interested in pursuing pediatrics as their career but 80% of them were not interested in pursuing pediatric oncology as their career. 55% of the students have not encountered any pediatric oncology patients in the ward. 40% did not have any lecture classes on pediatric oncology. 65.5% felt that their knowledge of childhood cancer did not make them competent to suspect and refer appropriately during their practice. 84% supported that there is a need to improve pediatric oncology teaching in their medical curriculum.Conclusions:The study unambiguously states that the future physicians lack confidence in identifying and managing childhood malignancies and pediatric oncology is far down in their career options. There is a need to reform the undergraduate medical students by increasing their exposure to pediatric oncology to improve their competence levels and interest in pursuing it as a career also.

Barriers to Cure for Children with Cancer in India and Strategies to Improve Outcomes: A Report by the Indian Pediatric Hematology Oncology Group

The survival of children with cancer in India is inferior to that of children in high-income countries. The Indian Pediatric Hematology Oncology Group (IPHOG) held a series of online meetings via www.Cure4kids.org to identify barriers to cure and develop strategies to improve outcomes. Five major hurdles were identified: delayed diagnosis, abandonment, sepsis, lack of co-operative groups, and relapse. Development of regional networks like IPHOG has allowed rapid identification of local causes of treatment failure for children with cancer in India and identification of strategies likely to improve care and outcomes in the participating centers. Next steps will include interventions to raise community awareness of childhood cancer, promote early diagnosis and referral, and reduce abandonment and toxic death at each center. Starting of fellowship programs in pediatric hemato-oncology, short training programs for pediatricians, publishing outcome data, formation of parent and patient support groups, choosing the right and effective treatment protocol, and setting up of bone marrow transplant services are some of the effective steps taken in the last decade, which needs to be supported further.

Delays in Diagnosis of Childhood Cancer in Southeastern Turkey and the Associated Factors

In childhood cancer patients, early diagnosis may have an impact on survival that reduces the potential morbidity. This study aimed to identify the factors associated with delay in diagnosis in children with cancer in southeastern Turkey. The clinical records of 682 patients with childhood cancer were evaluated. Study variables were classified as factors related to the patient, their disease, and the health care system. The median parental delay, physician delay, and total delay were determined as 20, 23, and 60 days, respectively. There was a significant relationship between parental delay, physician delay, and total delay and age at diagnosis (P = .005, P = .008, and P = .004, respectively). Long parental delay was least frequent in children younger than 1 year (P = .001). Parental, physician, and total delay were longer in patients with solid tumors than in patients with leukemias (P = .007, P = .000, and P = .000, respectively). Patients with tumors of the genitalia had longer physician delay and total delay than patients with other solid tumors (P = .001 and P = .000, respectively). Patients with solid tumor and early-stage disease had longer physician delay and total delay (P = .016 and P = .013, respectively). According to the first physician contacted, long physician delay was less frequent among pediatricians (P = .003). Delayed diagnosis was associated with age, type/localization and stage of tumor, the first physician consulted, and area of residence. A sustained effort should be made to raise the level of awareness of childhood cancer among parents and to sensitize all physicians, especially those who treat pediatric patients infrequently, with regard to the warning signs of the disease.

A prospective study on the attitude of post graduates in general pediatrics toward pediatric oncology subspeciality as a career.

Objectives:The health care scenario in India is experiencing an increase in the number of children affected with cancer and the number of pediatric oncologists available to treat these children are few and the awareness of childhood cancer is decimally low. Hence, the purpose of this study was to determine the attitude of post-graduate students of general pediatrics towards childhood cancer and to assess their interest in pursuing pediatric oncology as a specialty in their carrier.Materials and Methods:The study was conducted among 188 post-graduates hailing from various Medical colleges all over South India who were attending a 2 day workshop at Chennai. The survey was a 10 point questionnaire pertaining to their previous training, competence, interest toward the field of hematooncology. The data were analyzed by SPSS 18.V software.Results:Among the post-graduates, 74.7% of them reported that they did not have a pediatric oncology unit in their institution. 63.3% reported that they never been posted in pediatric oncology clinical postings before. 62% were not interested in pursuing pediatric oncology as a sub-specialty at all. 45.3% felt that pediatric oncology was too depressing to take as a specialty. 46.7% felt that late diagnosis and referral was the main factor which contributed to the failure of effective treatment of childhood cancers. 52.7% had never attended a class on pediatric oncology. 61.3% felt that they did not have sufficient knowledge to suspect and refer a child with cancer. 92% felt that there was a need to improve pediatric oncology teaching in their curriculum. 56.7% felt that the best way to imprint awareness on childhood malignancies was to improve pediatric oncology teaching in their medical curriculum.Conclusion:The results show that majority of post-graduates in pediatrics were not interested in pursuing pediatric oncology as a sub-specialty. The main reasons may be lack of specialized Pediatric oncology units in the majority of the medical institutions, lack of opportunity of these post-graduates to attend clinical postings and theory classes. They thus lack sufficient information in this field and hence do not want to take up a career in pediatric oncology.