Evaluation of pathway to diagnosis of paediatric brain tumours in South India

Background: The incidence of brain tumours in India equate to half of those in the developed world. Delayed diagnosis is associated with a higher risk of life-threatening neurological complications at presentation and poor cognitive outcomes amongst survivors. Early detection and treatment is crucial for improving outcomes. Aims: The aim of this study was to analyse baseline diagnostic intervals for paediatric brain tumours in Tamil Nadu. Methods: Data for this retrospective study was collected via questionnaire across 8 different hospitals in Tamil Nadu. It consisted of 14 questions where doctors were asked to record data items including the date of symptom onset, first presentation to healthcare and date of diagnosis. Results: 114 children were diagnosed with a brain tumour between January 2018 – October 2020. The average diagnostic interval was 9.3 weeks (median 3.5 weeks), and the average patient interval is 6.1 weeks (median 0.6 weeks.). Low-grade tumours had the longest median total diagnostic interval of 6.6 weeks. The median total diagnostic interval was significantly higher in villages (7.9 weeks), as compared to patients located in District (4.8 weeks) and cities (2.3 weeks). Conclusion: Overall, the diagnostic interval for paediatric brain tumours were comparable to data in the UK. Moreover, all patients received an MRI within a day, indicating excellent infrastructure.. However, many low-grade and optic pathway tumours were unaccounted for. Tamil Nadu has one of the best healthcare systems in India and extending this methodology to areas with poorer healthcare provisions, is required to get representative national data.