A comparison of trends in symptom interval for Low Grade Gliomas, Ependymomas, PNETs, Craniopharyngiomas and Rare tumour types in the North West region of England between the years 1954-2008

Introduction: Co-incidental with the launch of the ‘Head Smart’ campaign in the UK, we have benchmarked the presenting symptom interval to diagnosis for childhood brain tumours in the North West of England for a 55 year time period.Methods: The case notes and NW Children’s Cancer Registry records of patients diagnosed with the above tumour types between years 1954-2008 in the North West Region of England were investigated. Results: For children with LGG (n=554) the availability of the CT and then MRI scan was associated with a reduction in the symptom interval to diagnosis from approximately 10 months before 1975 (CT introduced), to a steady 5 months in the more modern treatment eras. In comparison, the time to diagnosis for ependymoma (n= 129) has remained steady at 1.7 – 2.4 months for the study period, and approximately 55% of children with PNET (n = 220) have been diagnosed within 6 weeks of first symptom since the mid 1960’s. However, there has been a significant increase in the number of patients presenting within 6 weeks the craniopharyngioma (n = 82) and rare tumour groups (n = 251), particularly choroid plexus tumours in the CT/MRI scan eras. Conclusion: Advances in neuro-imaging have been associated with reductions in the median time to diagnosis from first symptom for some, but not all brain tumours of childhood. The challenge to reduce the median time to diagnosis <6 weeks needs to be met for all tumour types in the NW of England.