The role of the pediatrician in the early diagnosis of malignant neoplasms in children

Abstract

Malignant neoplasms prevail in the structure of mortality in children all over the world, while most patients are diagnosed at the common stages; the second place is taken by external causes. It determines a particular relevance of developing new approaches to strengthen the role of district pediatricians in the early diagnosis of malignant neoplasms in children.Material and methods. The Algorithm for determining the appropriateness of referring a patient to a pediatric oncologist was introduced in the medical organizations of the Arkhangelsk region in 2016. To evalute the effectiveness of the Algorithm, we compared two groups of patients with histologically verified solid malignant neoplasms: Group 1: 49 patients who received medical care in the Arkhangelsk region in 2011–2015 (prior to the experiment); Group 2: 51 patients who received medical care in the Department of Pediatric Oncology of the Arkhangelsk region in 2016–2018. Results. The average survival time was significantly increased in Group 2016–2018 (30.3 ± 1.57 months) as compared with the survival time of patients receiving treatment in 2011–2015 (25.04 ± 2.05 months) (p=0.045). The following time parameters were reduced: from the moment of contacting the pediatric oncologist to the verification of the diagnosis – from 9.0 to 7.0 days; from verification of the diagnosis to the start of specialized treatment – from 12.0 to 8.0 days; from the moment of contacting the local pediatrician to the referral to the pediatric oncologist – from 11.0 to 2.0 days; from the moment of contacting the local pediatrician to the start of specialized treatment – from 23.0 to 9.0 days. Conclusion: The organizational experiment confirmed the effectiveness of the Algorithm and the expediency of its implementation in the medical organizations.