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.

Keywords:

Childhood cancer, Recognition, Symptom , Diagnosis,

PDF

___

Raab CP, Gartner JC Jr. Diagnosis of childhood cancer. Prim Care 2009;36:671-84. doi: 10.1016/j.pop.2009.07.002.
Fragkandrea I, Nixon JA, Panagopoulou P. Signs and symptoms of childhood cancer: a guide for early recognition. Am Fam Physician 2013;88:185-92.
Kutluk T, Yeşilipek A. Pediatrik tümör kayıtları. , T.P.O.G.T.P.H. Derneği, Editor. 2007.
Young G, Toretsky JA, Campbell AB, Eskenazi AE. Recognition of common childhood malignancies. Am Fam Physician 2000;61:2144-54. .
Youlden DR, Frazier AL, Gupta S, et al. Stage at diagnosis for childhood solid cancers in Australia: A population-based study. Cancer Epidemiol 2019;59:208-14. doi: 10.1016/j.canep.2019.02.013
Radhi M, Fulbright JM, Ginn KF, Guest EM. Childhood cancer for the primary care physician. Prim Care 2015;42:43-55. doi: 10.1016/j.pop.2014.09.006.
Signorelli C, Wakefield CE, Fardell JE, et al. Anzchog Survivorship Study Group. The role of primary care physicians in childhood cancer survivorship care: Multiperspective interviews. Oncologist 2018; 31:2018-0103. doi: 10.1634/theoncologist.2018-0103.
Minute M, Cozzi G, Plotti C, et al. Children with cancer: a survey on the experience of Italian primary care pediatricians. Ital J Pediatr 2017;43:48. doi: 10.1186/s13052.017.0365-9.
Bashore L. Childhood and adolescent cancer survivors’ knowledge of their disease and effects of treatment. J Pediatr Oncol Nurs 2004;21: 98-102. doi: 10.1177/104.345.4203262754
Moerdler S, Zhang L, Gerasimov E, et al. Physician perspectives on compassionate use in pediatric oncology. Pediatr Blood Cancer 2019;66:e27545. doi: 10.1002/pbc.27545
Workman G, Ribeiro RC, Rai SN, Pedrosa A, Workman DE, Pedrosa F. Pediatric cancer knowledge : assesment of knowledge of warning symptoms for pediatric cancer among Brazilian community health workers. J Cancer Educ 2007; 22:181-5. doi: 10.1007/BF03174334
Fragkandrea I, Nixon JA, Panagopoulou P. Signs and symptoms of childhood cancer: a guide for early recognition. Am Fam Physician 2013;88:185-92.
Aktan G, Cangar Ş, Serdaroğlu E. Pediatrik tümörlerde tanıda gecikme süresi. T Klinikleri Pediatri 1997; 6:97-102.
Pallock H, Krischer J, Teresa J. Interval between symptom onset and diagnosis of pediatric solid tumors. J Pediatr 1991;119:725-32. doi: 10.1016/s0022-3476(05)80287-2
Haimi M , Peretz Nahum M, Weyl Ben Arush M. Delay in diagnosis of children with cancer: A retrospective study of 315 children. Pediatr Hematol Oncol 2004;21:37-48.
Tan TD, Franco EL. Diagnosis delays in childhood cancer. Cancer 2007;110: 703-13. doi: 10.1002/cncr.22849
Gyasi RK, Tettey Y. Childhood deaths from malignant neoplasms in accra. Ghana Med J 2007;41:78-81. doi: 10.4314/ gmj.v41i2.55306.
Korde LA, Gadalla MS. Cancer risk assessment for the primary care physician. Prim Care Clin Office Pract 2009;36: 471-88.
Evans DG, Lunt P, Clancy T, Eeles R. Childhood predictive genetic testing for Li-Fraumeni syndrome. Fam Cancer 2009;9:65-9. doi: 10.1007/s10689.009.9245-9
Plon S. Childhood cancer and heredity. 5th ed. Principles and Practise of Pediatric Oncology, ed. P. Pizzo and D. Poplack. 2006, Philadelphia: Lippincott Williams and Wilkins. 2006:14-37.
Apak H. Çocukluk çağı lösemileri. Türk Pediatri Arşivi 2006; 41: 189 – 96
Forgie S, Robinson J. Pediatric malignancies presenting as a possible infectious disease. BMC Infect Dis 2007;7:44. doi: 10.1186/1471-2334-7-44
Park J L, Eggert A, Caron H. Neuroblastoma: biology, prognosis, and treatment. Hematol Oncol Clin N Am 2010;24:65-86. doi: 10.1016/j.hoc.2009.11.011
Perkins G, Slater ED, Sanders GK. Serum tumor markers. Am Fam Physician 2003;68: 1075-82.
Yaris N, Mandiracioglu A, Büyükpamukcu M. Childhood cancer in developing countries. Pediatr Hematol Oncol 2004;21:237-53. doi: 10.1080/088.800.10490276971
Zitzelsberger L, Grunfeld E, Graham LD. Physicians’ perspectives on practice guidelines related to cancer control. BMC Fam Pract 2004;5:25. doi: 10.1186/1471-2296-5-25
Nathan PC, Daugherty CK, Wroblewski KE, et al. Family physician preferences and knowledge gaps regarding the care of adolescent and young adult survivors of childhood cancer. J Cancer Surviv 2013;7:275-82. doi: 10.1007/s11764.013.0271-0.
Lawrence RA, McLoone JK, Wakefield CE, Cohn RJ. Primary care physicians’ perspectives of their role in cancer care: A systematic review. J Gen Intern Med 2016;31:1222-36. doi: 10.1007/s11606.016.3746-7.
Ruiter RA, De Nooijer J, Van Breukelen G, Ockhuysen- Vermey CF, de Vries H. Intended coping responses to cancer symptoms in healty adults: The roles of symptom knowledge, detection behaviour, and perceived threat. Cancer Epidemiol Biomarkers Prev 2008;17:818-26. doi: 10.1158/1055-9965. EPI-07-0015