{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T10:15:52Z","timestamp":1785838552064,"version":"3.56.0"},"reference-count":100,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Pediatric patients frequently experience long intervals between the initial onset of symptoms and the diagnosis of a brain tumor. Understanding the determinants of the prediagnostic symptomatic interval (PSI) has the potential to facilitate earlier initiation of treatment. Here, the authors studied the impact of demographic factors and social determinants of health on the PSI among pediatric brain tumor patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>All pediatric patients with brain tumors included in the Connecticut Department of Public Health\u2019s Tumor Registry from 2004 to 2018 were reviewed. Demographic, clinical, and outcomes data were collected. The primary outcome was the log transformation of the PSI (ln(PSI)), which was modeled as a continuous variable. Statistical analyses included multiple linear regression models with stepwise variable selection. The Akaike Information Criterion (AIC) was used to indicate model fit, and bootstrapping was performed to validate the findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Overall, 153 patients met the inclusion criteria with a median (IQR) PSI of 30 (14\u201360) days. Of the tumors, 91 (59.5%) were classified as malignant and 62 (40.5%) as benign. The multivariable linear regression analysis of ln(PSI) demonstrated that longer PSI was positively associated with older age (\u03b2 = 0.06, p = 0.004) and was negatively associated with Black or African American race (\u03b2 = \u22120.64, p = 0.023), the presence of hydrocephalus on presentation (\u03b2 = \u22120.79, p = 0.011), fatigue (\u03b2 = \u22120.61, p = 0.047) or hemiparesis (\u03b2 = \u22120.82, p = 0.041) as presenting symptoms, and malignant tumor behavior (\u03b2 = \u22120.45, p = 0.042). The multiple linear regression model was statistically significant overall (F(7,145) = 5.42, p &lt; 0.001), explaining approximately 21% of the variance ln(PSI), and bootstrapping with 1000 resamples confirmed the reliability of the regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>Demographic factors, patterns of presentation, and tumor biology play a role in the interval between symptom onset and the diagnosis of pediatric brain tumors, with potential implications for quality of care and survival. Although this study did not identify a significant association between nondemographic social determinants of health and the PSI, additional studies are needed with more granular measures of economic stability, healthcare access and quality, education access and quality, neighborhood and built environment, and social and community context. Future efforts should target patient populations at increased risk of a prolonged PSI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/2024.12.peds24394","type":"journal-article","created":{"date-parts":[[2025,3,29]],"date-time":"2025-03-29T20:29:20Z","timestamp":1743280160000},"page":"612-620","source":"Crossref","is-referenced-by-count":1,"title":["Demographic and social determinants of the interval from symptom onset to diagnosis of pediatric brain tumors: a study of the Connecticut Tumor Registry"],"prefix":"10.3171","volume":"35","author":[{"given":"William A.","family":"Lambert","sequence":"first","affiliation":[{"name":"Department of Neurological Surgery, University of Massachusetts Chan Medical School, Worcester, Massachusetts;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcus","family":"Alexander","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackson","family":"Ayers","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Connecticut Children\u2019s, Hartford;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amirul","family":"Anuar","sequence":"additional","affiliation":[{"name":"Research Operations and Development, Connecticut Children\u2019s, Hartford;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrina R.","family":"Swett","sequence":"additional","affiliation":[{"name":"Connecticut Tumor Registry, Connecticut Department of Public Health, Hartford;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lou","family":"Gonsalves","sequence":"additional","affiliation":[{"name":"Connecticut Tumor Registry, Connecticut Department of Public Health, Hartford;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan","family":"Cantor","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Connecticut Children\u2019s, Hartford;"},{"name":"Department of Pediatrics, UConn School of Medicine, Farmington; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan E.","family":"Martin","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Connecticut Children\u2019s, Hartford;"},{"name":"Department of Neurosurgery, UConn School of Medicine, Farmington, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Markus J.","family":"Bookland","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Connecticut Children\u2019s, Hartford;"},{"name":"Department of Neurosurgery, UConn School of Medicine, Farmington, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David S.","family":"Hersh","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Connecticut Children\u2019s, Hartford;"},{"name":"Department of Neurosurgery, UConn School of Medicine, Farmington, Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"7","key":"b1","series-title":"Childs Nerv Syst","first-page":"1067","article-title":"Delayed diagnosis of childhood low-grade glioma: causes, consequences, and potential solutions","volume":"31","author":"Arnautovic A","year":"2015","unstructured":"Arnautovic A, Billups C, Broniscer A, Gajjar A, Boop F, Qaddoumi I. Delayed diagnosis of childhood low-grade glioma: causes, consequences, and potential solutions. Childs Nerv Syst. 2015;31(7):1067\u20131077."},{"issue":"2","key":"b2","series-title":"J Neurooncol","first-page":"297","article-title":"Diagnostic delay and morbidity of central nervous system tumors in children and young adults: a pediatric hospital experience","volume":"143","author":"Patel V","year":"2019","unstructured":"Patel V, McNinch NL, Rush S. Diagnostic delay and morbidity of central nervous system tumors in children and young adults: a pediatric hospital experience. J Neurooncol. 2019;143(2):297\u2013304."},{"issue":"8","key":"b3","series-title":"Childs Nerv Syst","first-page":"2053","article-title":"Delay in the diagnosis of paediatric brain tumours: a systematic review","volume":"39","author":"Kehoe K","year":"2023","unstructured":"Kehoe K, Sivaguru H, Coulter I, Cowie C. Delay in the diagnosis of paediatric brain tumours: a systematic review. Childs Nerv Syst. 2023;39(8):2053\u20132063."},{"issue":"1","key":"b4","series-title":"Eur J Pediatr","first-page":"87","article-title":"Progression from first symptom to diagnosis in childhood brain tumours","volume":"171","author":"Wilne S","year":"2012","unstructured":"Wilne S, Collier J, Kennedy C,  Progression from first symptom to diagnosis in childhood brain tumours. Eur J Pediatr. 2012;171(1):87\u201393."},{"issue":"2","key":"b5","series-title":"Neurosurgery","first-page":"365","article-title":"Latency between symptom onset and diagnosis of pediatric brain tumors: an Eastern Canadian geographic study","volume":"51","author":"Mehta V","year":"2002","unstructured":"Mehta V, Chapman A, McNeely PD, Walling S, Howes WJ. Latency between symptom onset and diagnosis of pediatric brain tumors: an Eastern Canadian geographic study. Neurosurgery. 2002;51(2):365\u2013373."},{"issue":"2","key":"b6","series-title":"J Neurooncol","first-page":"427","article-title":"Clinical presentation of young people (10-24 years old) with brain tumors: results from the international MOBI-Kids study","volume":"147","author":"Zumel-Marne A","year":"2020","unstructured":"Zumel-Marne A, Kundi M, Casta\u00f1o-Vinyals G,  Clinical presentation of young people (10-24 years old) with brain tumors: results from the international MOBI-Kids study. J Neurooncol. 2020;147(2):427\u2013440."},{"issue":"3","key":"b7","series-title":"Br J Neurosurg","first-page":"364","article-title":"Time to diagnosis of paediatric posterior fossa tumours: an 11-year West of Scotland experience 2000-2011","volume":"27","author":"Kameda-Smith MM","year":"2013","unstructured":"Kameda-Smith MM, White MA, St George EJ, Brown JI. Time to diagnosis of paediatric posterior fossa tumours: an 11-year West of Scotland experience 2000-2011. Br J Neurosurg. 2013;27(3):364\u2013369."},{"issue":"7","key":"b8","series-title":"Pediatr Blood Cancer","first-page":"1190","article-title":"Duration of the pre-diagnostic interval in medulloblastoma is subgroup dependent","volume":"61","author":"Ramaswamy V","year":"2014","unstructured":"Ramaswamy V, Remke M, Shih D,  Duration of the pre-diagnostic interval in medulloblastoma is subgroup dependent. Pediatr Blood Cancer. 2014;61(7):1190\u20131194."},{"issue":"6","key":"b9","series-title":"Pediatr Int","first-page":"829","article-title":"Duration between onset and diagnosis in central nervous system tumors: impact on prognosis and functional outcome","volume":"56","author":"Fukuoka K","year":"2014","unstructured":"Fukuoka K, Yanagisawa T, Suzuki T,  Duration between onset and diagnosis in central nervous system tumors: impact on prognosis and functional outcome. Pediatr Int. 2014;56(6):829\u2013833."},{"issue":"2","key":"b10","series-title":"J Neurosurg Pediatr","first-page":"242","article-title":"Healthcare disparities in pediatric neurosurgery: a scoping review","volume":"32","author":"Maddy K","year":"2023","unstructured":"Maddy K, Eliahu K, Bryant JP,  Healthcare disparities in pediatric neurosurgery: a scoping review. J Neurosurg Pediatr. 2023;32(2):242\u2013253."},{"issue":"1","key":"b11","series-title":"Sci Rep","first-page":"4588","article-title":"Population-based analysis of demographic and socioeconomic disparities in pediatric CNS cancer survival in the United States","volume":"10","author":"Fineberg R","year":"2020","unstructured":"Fineberg R, Zahedi S, Eguchi M, Hart M, Cockburn M, Green AL. Population-based analysis of demographic and socioeconomic disparities in pediatric CNS cancer survival in the United States. Sci Rep. 2020;10(1):4588."},{"issue":"1","key":"b12","series-title":"Neurosurgery","first-page":"108","article-title":"Social determinants of health and associations with outcomes in pediatric patients with brain tumors","volume":"94","author":"Aguirre AO","year":"2024","unstructured":"Aguirre AO, Lim J, Kuo CC,  Social determinants of health and associations with outcomes in pediatric patients with brain tumors. Neurosurgery. 2024;94(1):108\u2013116."},{"issue":"1","key":"b13","series-title":"Pediatr Blood Cancer","first-page":"e28738","article-title":"Racial and ethnic disparities in survival of children with brain and central nervous tumors in the United States","volume":"68","author":"Haizel-Cobbina J","year":"2021","unstructured":"Haizel-Cobbina J, Spector LG, Moertel C, Parsons HM. Racial and ethnic disparities in survival of children with brain and central nervous tumors in the United States. Pediatr Blood Cancer. 2021;68(1):e28738."},{"issue":"2","key":"b14","series-title":"Pediatr Blood Cancer","first-page":"e27501","article-title":"Racial and ethnic differences in survival of pediatric patients with brain and central nervous system cancer in the United States","volume":"66","author":"Siegel DA","year":"2019","unstructured":"Siegel DA, Li J, Ding H, Singh SD, King JB, Pollack LA. Racial and ethnic differences in survival of pediatric patients with brain and central nervous system cancer in the United States. Pediatr Blood Cancer. 2019;66(2):e27501."},{"issue":"5","key":"b15","series-title":"J Neurosurg Pediatr","first-page":"585","article-title":"Health disparities and impact on outcomes in children with primary central nervous system solid tumors","volume":"18","author":"Austin MT","year":"2016","unstructured":"Austin MT, Hamilton E, Zebda D,  Health disparities and impact on outcomes in children with primary central nervous system solid tumors. J Neurosurg Pediatr. 2016;18(5):585\u2013593."},{"issue":"5","key":"b16","series-title":"Cancer Causes Control","first-page":"587","article-title":"Pediatric brain tumors in non-Hispanics, Hispanics, African Americans and Asians: differences in survival after diagnosis","volume":"16","author":"Barnholtz-Sloan JS","year":"2005","unstructured":"Barnholtz-Sloan JS, Severson RK, Stanton B, Hamre M, Sloan AE. Pediatric brain tumors in non-Hispanics, Hispanics, African Americans and Asians: differences in survival after diagnosis. Cancer Causes Control. 2005;16(5):587\u2013592."},{"issue":"12","key":"b17","series-title":"CMAJ","first-page":"E459","article-title":"Improving diagnosis of pediatric central nervous system tumours: aiming for early detection","volume":"189","author":"Goldman RD","year":"2017","unstructured":"Goldman RD, Cheng S, Cochrane DD. Improving diagnosis of pediatric central nervous system tumours: aiming for early detection. 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Childs Nerv Syst. 2023;39(11):3169\u20133177."},{"issue":"13","key":"b33","series-title":"Eur J Cancer","first-page":"2028","article-title":"A long duration of the prediagnostic symptomatic interval is not associated with an unfavourable prognosis in childhood medulloblastoma","volume":"48","author":"Gerber NU","year":"2012","unstructured":"Gerber NU, von Hoff K, von Bueren AO,  A long duration of the prediagnostic symptomatic interval is not associated with an unfavourable prognosis in childhood medulloblastoma. Eur J Cancer. 2012;48(13):2028\u20132036."},{"issue":"7","key":"b34","series-title":"Support Care Cancer","first-page":"3633","article-title":"Factors impacting time to diagnosis in pediatric CNS tumors in Chinese children","volume":"29","author":"Lu P","year":"2021","unstructured":"Lu P, Raynald M, Liu W,  Factors impacting time to diagnosis in pediatric CNS tumors in Chinese children. 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J Clin Oncol. 2010;28(32):4783\u20134789."},{"issue":"4","key":"b39","series-title":"Pediatrics","first-page":"e688","article-title":"Disparities in access to pediatric neurooncological surgery in the United States","volume":"124","author":"Mukherjee D","year":"2009","unstructured":"Mukherjee D, Kosztowski T, Zaidi HA,  Disparities in access to pediatric neurooncological surgery in the United States. Pediatrics. 2009;124(4):e688\u2013e696."},{"issue":"2","key":"b40","series-title":"J Neurosurg Pediatr","first-page":"159","article-title":"Social determinants of health affecting treatment of pediatric brain tumors","volume":"24","author":"Berkman JM","year":"2019","unstructured":"Berkman JM, Dallas J, Lim J,  Social determinants of health affecting treatment of pediatric brain tumors. 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J Neurooncol. 2009;93(1):25\u201339."},{"key":"b43","series-title":"Pediatr Neurol","first-page":"27","article-title":"From symptom to diagnosis\u2014the prediagnostic symptomatic interval of pediatric central nervous system tumors in Austria","volume":"76","author":"Azizi AA","year":"2017","unstructured":"Azizi AA, He\u00dfler K, Leiss U,  From symptom to diagnosis\u2014the prediagnostic symptomatic interval of pediatric central nervous system tumors in Austria. Pediatr Neurol. 2017;76:27\u201336."},{"issue":"20","key":"b44","series-title":"Cancer","first-page":"3157","article-title":"Influence of insurance status on survival of adults with glioblastoma multiforme: a population-based study","volume":"122","author":"Rong X","year":"2016","unstructured":"Rong X, Yang W, Garzon-Muvdi T,  Influence of insurance status on survival of adults with glioblastoma multiforme: a population-based study. 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