Factors Leading to Delay in Diagnosis of Childhood Cancer in Pakistan


  • Sarah Bano Fellow Pediatric Hematology Oncology Indus hospital and health network Karachi
  • Muhammad Rafie Raza Head of department Pediatric Hematology Oncology Indus hospital and health network Karachi
  • Namrita Rai Program coordinator Department of pediatric Haematology oncology Indus hospital and health network Karachi
  • Muhammad Shamvil Ashraf Pediatric Haematologist oncologist Executive director medical services Indus hospital and health network Karachi
  • Meher Afroze Fellow Paediatric Haematology oncology Indus hospital and health network Karachi


Introduction: Childhood cancer is a distressing and life-threatening disease, and early diagnosis is crucial for successful treatment and improved outcomes. Unfortunately, there are often delays in diagnosing childhood cancer due to various factors. Recognizing and addressing these factors is essential to enhance the diagnostic process and improve outcomes of affected children.

Objective: To evaluate the factors leading to the delay in diagnosis of childhood cancers.

Material and methods: This prospective cross-sectional study was conducted at the pediatric Hematology/Oncology Department of Indus Hospital & Health Network (IHHN) Karachi Pakistan. All children aged 4 months to 14 years diagnosed with malignancy were included. Parents were interviewed for reasons of delay in the diagnosis of their children. Delay in the diagnosis was defined as the patient not diagnosed on the primary health facilities, delaying diagnostic history will be considered as responsible factor. For hematological malignancy 4 weeks is considered as delay and in solid tumors 6 weeks is considered as delay. Data was entered and analyzed using SPSS version 26.0.

Results: The average age of the participants was approximately 7.45+4.10 years. 67.5% children were male, 70.2% children had an intermediate nutritional status and 4.3% had poor nutritional status. The most common malignant diagnoses among the children were leukemia, accounting for 45.5% of cases, followed by lymphoma at 17.6%, and bone tumors at 7.5%. Regarding the reasons behind the delay in diagnosis, 22.4% of cases were postponed due to living away from healthcare facilities, 28.6% of cases were held up due to poor socioeconomic status. Moreover, 33.3% of cases faced delays resulting from misdiagnosis, 13.3% were impeded by transportation issues, and 19.6% encountered delays due to ignorance.

Conclusion: Delay in childhood cancer diagnosis is a multifaceted problem involving various interconnected factors, like limited access to healthcare facilities, socioeconomic disadvantages, misdiagnosis, and transportation barriers. Cultural beliefs and preference for alternative treatments can further delay early interventions.

key words: children, malignancies, delay in diagnosis, factors





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