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Chu, T.P.; Shah, A.; Walker, D.; Coleman, M.P. (2016)
Publisher: Elsevier
Languages: English
Types: Article
Childhood brain tumours have some of the longest time to diagnosis. A timely diagnosis may have a role in reducing anxiety in waiting for a diagnosis and subsequent morbidity and mortality. We investigated where the opportunities for an earlier diagnosis were, and for which anatomical locations this strategy will most likely to be effective. A record-linkage cohort study of patients diagnosed aged 0-24 years with a primary intracranial tumour between 1989 and 2006 in England, using records from the National Cancer Registry linked to hospital admission records from Hospital Episode Statistics (HES, 1997-2006) and primary care consultation records from Clinical Practice Research Datalink (CPRD, 1989-2006). Relevant neurological presentations were extracted from HES and CPRD. Temporal changes in presentation rates were estimated in generalised additive models. Frequency of presentation began to increase six months before diagnosis in primary care and three months before diagnosis in hospital. Supratentorial and midline tumours had the longest presentation history before diagnosis. Peri-ventricular tumours presented frequently in hospital (rate ratio = 1.29 vs supratentorial tumours; 95% CI = 1.12-1.48) or as an emergency (1.24; 1.01-1.51), and in primary care (1.12; 0.62-1.85). Opportunities for an earlier diagnosis are greater in supratentorial, midline or cranial nerve tumours, which have a longer presentation history than peri-ventricular, cerebellar or brainstem tumours. Common features before diagnosis include headache, convulsions, and growth or endocrine disorders. Focal neurological deficits are uncommon and emerge late in the pre-diagnosis period.
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    • 1. Stiller C. Childhood Cancer in Britain: Incidence, survival, mortality. Oxford, UK: Oxford University Press; 2007.
    • 2. Coserria Sanchez JF, Garrido Ocana AI, Quiroga Cantero E, Reina Gonzalez AM, Amadeu Da Costa AP, Garcia Zarza N. [Presenting signs and symptoms of central nervous system tumors according to age]. An Pediatr (Barc). 2007 Feb;66(2):115-20
    • 3. Dommett RM, Redaniel MT, Stevens MC, Hamilton W, Martin RM. Features of childhood cancer in primary care: a population-based nested case-control study. Br J Cancer. 2012 Feb 28;106(5):982-7
    • 4. Dommett RM, Redaniel MT, Stevens MC, Hamilton W, Martin RM. Features of cancer in teenagers and young adults in primary care: a population-based nested case-control study. Br J Cancer. 2013 Jun 11;108(11):2329-33
    • 5. Vazquez Roman S, Martinez Anton A, Llorente Otones L, Rojo Conejo P, Hinojosa Bernal J. [Initial signs and symptoms of brain tumors in children]. Neurologia. 2008 May;23(4):215-9
    • 6. Wilne S, Collier J, Kennedy C, Koller K, Grundy R, Walker D. Presentation of childhood CNS tumours: a systematic review and meta-analysis. Lancet Oncol. 2007 Aug;8(8):685-95
    • 7. Wilne S, Koller K, Collier J, Kennedy C, Grundy R, Walker D. The diagnosis of brain tumours in children: a guideline to assist healthcare professionals in the assessment of children who may have a brain tumour. Arch Dis Child. 2010 Jul;95(7):534-9
    • 8. National Collaborating Centre for Cancer. Suspected cancer: recognition and referral: National Institute for Health and Care Excellence; 2015.
    • 9. Neuro-Oncology Group, James Lind Alliance. Top 10 priorities for clinical research in primary brain and spinal cord tumours: Final report of the James Lind Alliance Priority Setting Partnership in Neuro-Oncology.
    • 10. The James Lind Alliance. James Lind Alliance: Priority Setting Partnerships 2016 [16 May 2016]. Available from: http://www.jla.nihr.ac.uk.
    • 11. Fellegi IP, Sunter AB. A Theory for Record Linkage. Journal of the American Statistical Association. 1969;64(328):1183-210
    • 12. Gill L. Methods for Automatic Record Matching and Linkage and their Use in National Statistics. Norwich, UK: Her Majesty's Stationery Office; 2001.
    • 13. Chu TP, Shah A, Walker D, Coleman MP. Pattern of symptoms and signs of primary intracranial tumours in children and young adults: a record linkage study. Arch Dis Child. 2015 Dec;100(12):1115-22
    • 14. Kariyawasam DS, McShane T. Brain tumours in paediatrics: when should they be suspected? Arch Dis Child. 2015 Dec;100(12):1102-3
    • 15. Steliarova-Foucher E, Stiller C, Lacour B, Kaatsch P. International Classification of Childhood Cancer, third edition. Cancer. 2005 Apr 1;103(7):1457-67
    • 16. World Health Organization. Manual of the international statistical classification of diseases, injuries, and causes of death. Geneva, Switzerland: World Health Organization; 1977.
    • 17. World Health Organization. International statistical classification of diseases and related health problems. Geneva, Switzerland: World Health Organization; 1992.
    • 18. Coleman MP, Babb P, Damiecki P, Grosclaude P, Honjo S, Jones J, et al. Cancer survival trends in England and Wales, 1971-1995: deprivation and NHS region. London, UK: The Stationery Office; 1999.
    • 19. GPRD. The General Practice Research Database. London, UK: GPRD; 2011.
    • 20. Herrett E, Gallagher AM, Bhaskaran K, Forbes H, Mathur R, van Staa T, et al. Data Resource Profile: Clinical Practice Research Datalink (CPRD). Int J Epidemiol. 2015 Jun;44(3):827-36
    • 21. Herrett E, Thomas SL, Schoonen WM, Smeeth L, Hall AJ. Validation and validity of diagnoses in the General Practice Research Database: a systematic review. Br J Clin Pharmacol. 2010 Jan;69(1):4-14
    • 22. Health and Social Care Information Centre. The processing cycle and HES data quality Leeds, UK: Health and Social Care Information Centre; 2016 [1 March 2016]. Available from: http://www.hscic.gov.uk/article/1825/The-processing-cycle-and-HESdataquality.
    • 23. Hanchett N. ONS to HES Linkage Release 1: Core Documentation. London, UK: Thames Cancer Registry, King's College London; 2008.
    • 24. Thames Cancer Registry. National Cancer Data Repository - 1990 to 2008: Matching Registry Records to Hospital Episodes Version 1.2. London, UK: Thames Cancer Registry, King's College London; 2011.
    • 25. General Practice Research Database. GPRD Medical Browser, version 1.3.1. London, UK: Medicines and Healthcare products Regulatory Agency; 2010.
    • 26. International Agency for Research on Cancer, International Association of Cancer Registries. Cancer Registration: Principles and Methods. Jensen OM, Parkin DM, MacLennan R, Muir CS, Skeet RG, editors. Lyon, France: International Agency for Research on Cancer; 1991.
    • 27. United Kingdom Association of Cancer Registries. Po/99/03 Definition of Diagnosis Date. United Kingdom Association of Cancer Registries; 2011.
    • 28. Ansell P, Johnston T, Simpson J, Crouch S, Roman E, Picton S. Brain tumor signs and symptoms: analysis of primary health care records from the UKCCS. Pediatrics. 2010 Jan;125(1):112-9
    • 29. Chambers J, Hastie T. Statistical Models in S. London, UK: Chapman & Hall; 1993.
    • 30. Cleveland WS. Robust Locally Weighted Regression and Smoothing Scatterplots. Journal of the American Statistical Association. 1979;74(368):829-36
    • 31. Cleveland WS, Devlin SJ. Locally Weighted Regression - an Approach to Regression-Analysis by Local Fitting. Journal of the American Statistical Association. 1988 Sep;83(403):596-610
    • 32. Hastie T. gam: Generalized Additive Models. 2011.
    • 33. R Core Team. R: A Language and Environment for Statistical Computing. Vienna, Austria2011.
    • 34. Louis DN, Ohgaki H, Wiestler OD, Cavenee WK, Burger PC, Jouvet A, et al. The 2007 WHO classification of tumours of the central nervous system. Acta Neuropathol. 2007 Aug;114(2):97-109
    • 35. Wilne SH, Ferris RC, Nathwani A, Kennedy CR. The presenting features of brain tumours: a review of 200 cases. Arch Dis Child. 2006 Jun;91(6):502-6
    • 36. Crossman AR, Neary D. Neuroanatomy: an illustrated colour text. Edinburgh, UK: Churchill Livingstone; 2005.
    • 37. Sinnatamby C. Last's Anatomy - Regional and Applied. Edinburgh, UK: Churchill Livingstone; 1999.
    • 38. Ogilvie C, Evans C. Chamberlain's Symptoms and Signs in Clinical Medicine: An Introduction to Medical Diagnosis. Oxford, UK: Butterworth-Heinemann; 1997.
    • 39. National Institute for Health and Clinical Excellence. Epilepsies: diagnosis and management. London, UK: National Institute for Health and Care Excellence; 2011.
    • 40. Hamilton W, Kernick D. Clinical features of primary brain tumours: a case-control study using electronic primary care records. Br J Gen Pract. 2007 Sep;57(542):695-9
    • 41. Weller D, Vedsted P, Rubin G, Walter FM, Emery J, Scott S, et al. The Aarhus statement: improving design and reporting of studies on early cancer diagnosis. Br J Cancer. 2012 Mar 27;106(7):1262-7
    • 42. Davies E, Clarke C. Early symptoms of brain tumours. J Neurol Neurosurg Psychiatry. 2004 Aug;75(8):1205-6
    • 43. Dixon-Woods M, Findlay M, Young B, Cox H, Heney D. Parents' accounts of obtaining a diagnosis of childhood cancer. Lancet. 2001 Mar 3;357(9257):670-4
    • 44. Gordon GS, Wallace SJ, Neal JW. Intracranial tumours during the first two years of
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