PMID- 37787020
OWN - NLM
STAT- MEDLINE
DCOM- 20231023
LR  - 20231103
IS  - 2045-7634 (Electronic)
IS  - 2045-7634 (Linking)
VI  - 12
IP  - 19
DP  - 2023 Oct
TI  - Early death from childhood cancer: First medical record-level analysis reveals 
      insights on diagnostic timing and cause of death.
PG  - 20201-20211
LID - 10.1002/cam4.6609 [doi]
AB  - BACKGROUND: Approximately 7.5% of pediatric cancer deaths occur in the first 
      30 days post diagnosis, termed early death (ED). Previous database-level analyses 
      identified increased ED in Black/Hispanic patients, infants, late adolescents, 
      those in poverty, and with specific diagnoses. Socioeconomic and clinical risk 
      factors have never been assessed at the medical record level and are poorly 
      understood. METHODS: We completed a retrospective case-control study of oncology 
      patients diagnosed from 1995 to 2016 at Children's Hospital Colorado. The ED 
      group (n = 45) was compared to a non-early death (NED) group surviving >31 days, 
      randomly selected from the same cohort (n = 44). Medical records and death 
      certificates were manually reviewed for sociodemographic and clinical information 
      to identify risk factors for ED. RESULTS: We identified increased ED risk in 
      central nervous system (CNS) tumors and, specifically, high-grade glioma and 
      atypical teratoid/rhabdoid tumor. There was prolonged time from symptom onset to 
      seeking care in the ED group (29.4 vs. 9.8 days) with similar time courses to 
      diagnosis thereafter. Cause of death was most commonly from tumor progression in 
      brain/CNS tumors and infection in hematologic malignancies. CONCLUSIONS: In this 
      first medical record-level analysis of ED, we identified socioeconomic and 
      clinical risk factors. ED was associated with longer time from first symptoms to 
      presentation, suggesting that delayed presentation may be an addressable risk 
      factor. Many individual patient-level risk factors, including socioeconomic 
      measures and barriers to care, were unable to be assessed through record review, 
      highlighting the need for a prospective study to understand and address childhood 
      cancer ED.
CI  - (c) 2023 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
FAU - Lind, Katherine T
AU  - Lind KT
AUID- ORCID: 0000-0003-1207-8457
AD  - Department of Pediatrics, Center for Cancer and Blood Disorders, Children's 
      Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, 
      USA.
FAU - Molina, Elizabeth
AU  - Molina E
AD  - Population Health Shared Resource University of Colorado Cancer Center, Aurora, 
      Colorado, USA.
FAU - Mellies, Amy
AU  - Mellies A
AD  - Population Health Shared Resource University of Colorado Cancer Center, Aurora, 
      Colorado, USA.
FAU - Schneider, Kami Wolfe
AU  - Schneider KW
AD  - Department of Pediatrics, Center for Cancer and Blood Disorders, Children's 
      Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, 
      USA.
FAU - Daley, William
AU  - Daley W
AD  - Department of Pediatrics, Center for Cancer and Blood Disorders, Children's 
      Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, 
      USA.
FAU - Green, Adam L
AU  - Green AL
AD  - Department of Pediatrics, Center for Cancer and Blood Disorders, Children's 
      Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado, 
      USA.
LA  - eng
GR  - P30AC046934/CA/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20231003
PL  - United States
TA  - Cancer Med
JT  - Cancer medicine
JID - 101595310
SB  - IM
MH  - Infant
MH  - Adolescent
MH  - Humans
MH  - Child
MH  - Retrospective Studies
MH  - Case-Control Studies
MH  - Prospective Studies
MH  - Cause of Death
MH  - *Central Nervous System Neoplasms
PMC - PMC10587965
OTO - NOTNLM
OT  - access to care
OT  - childhood cancer
OT  - disparities
OT  - early death
OT  - neoplasm
OT  - pediatrics
COIS- The authors have no conflicts of interest to disclose.
EDAT- 2023/10/03 06:47
MHDA- 2023/10/23 01:18
PMCR- 2023/10/03
CRDT- 2023/10/03 05:33
PHST- 2023/07/28 00:00 [revised]
PHST- 2023/05/11 00:00 [received]
PHST- 2023/09/22 00:00 [accepted]
PHST- 2023/10/23 01:18 [medline]
PHST- 2023/10/03 06:47 [pubmed]
PHST- 2023/10/03 05:33 [entrez]
PHST- 2023/10/03 00:00 [pmc-release]
AID - CAM46609 [pii]
AID - 10.1002/cam4.6609 [doi]
PST - ppublish
SO  - Cancer Med. 2023 Oct;12(19):20201-20211. doi: 10.1002/cam4.6609. Epub 2023 Oct 3.