{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:26:30Z","timestamp":1791912390269,"version":"4.3.4"},"reference-count":55,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,7,6]],"date-time":"2025-07-06T00:00:00Z","timestamp":1751760000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Retinoblastoma mortality remains high in many low\u2010 and middle\u2010income countries (LMICs), primarily due to delayed diagnosis and treatment. While efforts have been made to implement systematic population\u2010level screening, its feasibility remains limited, except in patients with a germline <jats:italic>RB1<\/jats:italic> mutation or a family history of retinoblastoma. Screening for retinoblastoma faces significant challenges, including the lack of a reliable, widely available test with high sensitivity and specificity. Smartphone applications and red\u2010reflex eye testing have shown potential for detecting leukocoria, but their utility in real\u2010world settings remains uncertain. To improve outcomes in LMICs, early diagnosis actions are strongly recommended. This requires not only timely detection but also ensuring that patients reach centers of excellence promptly and are efficiently referred and diagnosed, while minimizing treatment abandonment. Strengthening early diagnosis efforts through public awareness campaigns, educating primary care providers, and streamlining referral pathways is essential. These initiatives are expected to improve disease\u2010free survival, reduce the proportion of cases diagnosed at the extraocular stage, and enable diagnosis at a younger age. Prioritizing robust early diagnosis by reinforcing the healthcare system, ensuring universal access to specialized retinoblastoma centers, and implementing abandonment reduction programs is likely to be more effective than universal screening.<\/jats:p>","DOI":"10.1002\/pbc.31859","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T01:10:27Z","timestamp":1751850627000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Challenges for Early Diagnosis in Retinoblastoma in Low\u2010 and Middle\u2010Income Countries"],"prefix":"10.1002","volume":"72","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9375-9336","authenticated-orcid":false,"given":"Guillermo L.","family":"Chantada","sequence":"first","affiliation":[{"name":"Pediatric Cancer Center Barcelona, Hospital Sant Joan de D\u00e9u  Barcelona Spain"},{"name":"Fundaci\u00f3n P\u00e9rez\u2010Scremini  Montevideo Uruguay"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6159-1882","authenticated-orcid":false,"given":"Gabriela","family":"Villanueva","sequence":"additional","affiliation":[{"name":"Hospital de Cl\u00ednicas Jos\u00e9 de San Mart\u00edn  Buenos Aires Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David H.","family":"Abramson","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,7,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2024.4140"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3928\/01913913-20171116-03"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.81.7.559"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/13816810.2024.2388579"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2009.168062"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/10428190701882179"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/GO.24.00034"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MPH.0b013e31821d18f9"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.3109\/13816818909009874"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2019.6716"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1600-0420.1998.760316.x"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.3390\/cancers13153646"},{"key":"e_1_2_11_14_1","volume-title":"GeneReviews","author":"Lohmann D. 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