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Article |

Delay in the Diagnosis of Leukemia

Max Bader, MD, MPH
Am J Dis Child. 1987;141(3):244. doi:10.1001/archpedi.1987.04460030022012.
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Sir.—Flores et al1 noted that only 38% of primary brain tumors were diagnosed within the first month after onset of symptoms, in contrast to 84% of Wilms' tumors and 80% of acute leukemias. I checked back on an epidemiologic study of acute childhood leukemias among children under age 20 years in the state of Washington 25 years ago (M.B., unpublished data, 1961). At that time, only 40% of the children had their conditions diagnosed within a month of symptom onset. Moreover, the entire curve of cumulative percentage of patients with diagnosed conditions plotted against symptom duration prior to diagnosis matched that of the brain tumor curve in the study by Flores and colleagues. In the earlier study, the leukemia victims often had rather vague symptoms at the onset of disease that were recognizable as part of their disease only inin retrospect. The delay was usually in seeking medical


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