Multicentre service evaluation of presentation of newly diagnosed cancers and type 1 diabetes in children in the UK during the COVID-19 pandemic

Gemma Williams, Ross Mclean, Jo-Fen Liu, Timothy A. Ritzmann, Madhumita Dandapani, Dhurgshaarna Shanmugavadivel, Pooja Sachdev, Mark Brougham, Rod T. Mitchell, Nicholas T. Conway, James Law, Alice Cunnington, Gbemi Ogunnaike, Karen Brougham, Elizabeth Bayman, David Walker (Lead / Corresponding author)

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Abstract

Background: The COVID-19 pandemic led to changes in patterns of presentation to emergency departments. Child health professionals were concerned that this could contribute to the delayed diagnosis of life-threatening conditions, including childhood cancer (CC) and type 1 diabetes (T1DM). Our multicentre, UK-based service evaluation assessed diagnostic intervals and disease severity for these conditions.

Methods: We collected presentation route, timing and disease severity for children with newly diagnosed CC in three principal treatment centres and T1DM in four centres between 1 January and 31 July 2020 and the corresponding period in 2019. Total diagnostic interval (TDI), patient interval (PI), system interval (SI) and disease severity across different time periods were compared.

Results: For CCs and T1DM, the route to diagnosis and severity of illness at presentation were unchanged across all time periods. Diagnostic intervals for CCs during lockdown were comparable to that in 2019 (TDI 4.6, PI 1.1 and SI 2.1 weeks), except for an increased PI in January–March 2020 (median 2.7 weeks). Diagnostic intervals for T1DM during lockdown were similar to that in 2019 (TDI 16 vs 15 and PI 14 vs 14 days), except for an increased PI in January–March 2020 (median 21 days).

Conclusions: There is no evidence of diagnostic delay or increased illness severity for CC or T1DM, during the first phase of the pandemic across the participating centres. This provides reassuring data for children and families with these life-changing conditions.
Original languageEnglish
Article numbere001078
Number of pages10
JournalBMJ Paediatrics Open
Volume5
Issue number1
Early online date11 Nov 2021
DOIs
Publication statusPublished - 11 Nov 2021

Keywords

  • COVID-19

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