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  • 1187 A multi-centre service evaluation of the impact of the COVID-19 pandemic on presentation of newly diagnosed cancers and type 1 diabetes in children in the UK

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British Association of General Paediatrics
1187 A multi-centre service evaluation of the impact of the COVID-19 pandemic on presentation of newly diagnosed cancers and type 1 diabetes in children in the UK
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  1. David Walker1,
  2. Ross McLean2,
  3. Jo-Fen Liu3,
  4. Timothy Ritzmann4,
  5. Madhumita Dandapani5,
  6. Dhurgshaarna Shanmugavadivel6,
  7. Pooja Sachdev7,
  8. Mark Brougham8,
  9. Rod Mitchell9,
  10. Nicholas Conway10,
  11. David Walker1,
  12. James Law7,
  13. Alice Cunnington11,
  14. Gbemi Ogunnaike12,
  15. Karen Brougham13,
  16. Elizabeth Bayman14,
  17. Gemma Williams15
  1. 1Children’s Brain Tumour Research Centre, University of Nottingham
  2. 2University Hospital Wishaw, NHS Lanarkshire
  3. 3Children’s Brain Tumour Research Centre, University of Nottingham
  4. 4Children’s Brain Tumour Research Centre, University of Nottingham; Nottingham University Hospitals NHS Trust, Nottingham
  5. 5Children’s Brain Tumour Research Centre, University of Nottingham; Nottingham University Hospitals NHS Trust
  6. 6Division of Child Health, School of Medicine, University of Nottingham
  7. 7Department of Paediatric Diabetes and Endocrinology, Nottingham University Hospitals NHS Trust
  8. 8Royal Hospital for Sick Children, Edinburgh
  9. 9MRC Centre for Reproductive Health, The University of Edinburgh; Department of Paediatric Diabetes and Endocrinology, Royal Hospital for Sick Children, Edinburgh
  10. 10Tayside Children’s Hospital, NHS Tayside; Division of Population Health and Genomics, University of Dundee
  11. 11Nottingham University Hospitals NHS Trust, Nottingham, UK
  12. 12Nottingham University Hospitals NHS Trust
  13. 13Department of Paediatric Oncology, Royal Hospital for Sick Children, Edinburgh
  14. 14Department of Paediatric Diabetes and Endocrinology, Royal Hospital for Sick Children, Edinburgh
  15. 15Leeds Children’s Hospital, Leeds Teaching Hospital NHS Trust

Abstract

Background The COVID-19 pandemic led to changes in patterns of presentation to Emergency Departments. Child health professionals were concerned that this could contribute to the delayed diagnosis of life-threatening conditions, including childhood cancer (CC) and type 1 diabetes (T1DM).

Objectives Our multicentre, UK-based service evaluation assessed diagnostic intervals and disease severity for these conditions.

Methods We collected presentation route, timing and disease severity for children with newly diagnosed CC in three principal treatment centres between January-June 2020 and T1DM in four centres between January-July 2020. We compared these to the corresponding period in 2019. The impact of lockdown on total diagnostic interval (TDI), patient interval (PI), system interval (SI) and disease severity were evaluated.

Results Children with new diagnosis of CC (n=253) and T1DM (n=187) were included in the analysis. Overall there was a 17% reduction (138 vs 115) in number of incident CC cases and 9% reduction (98 vs 89) in T1DM cases between 2019 and 2020, with some regional variation. No significant differences in gender, ethnic background or age at diagnosis between study periods were observed. The route to diagnosis and severity of illness at presentation were unchanged across all time periods.

Median diagnostic interval for CCs during lockdown was comparable to that in 2019 (TDI 4.6, PI 1.1 and SI 2.1 weeks), except for an increased PI during pre-lockdown period Jan-Mar 2020 (2.7 weeks) (table 1). Median diagnostic interval for T1DM during lockdown was similar to that in 2019 (TDI 16 vs 15 and PI 14 vs 14 days), except for an increased PI in pre-lockdown period Jan-Mar 2020 (21 days) (table 2).

View this table:
Absract 1187 Table 1

Summary of time to diagnosis and disease severity of the study population (253 childhood cancer and 187 T1DM incident cases)

Conclusions There is no evidence of diagnostic delay or increased illness severity for CC or T1DM during the first lockdown in the participating centres. This provides reassuring data for children and families with these life-changing conditions. Data collection at a more comprehensive national level would provide greater clarity on diagnostic intervals.

https://doi.org/10.1136/archdischild-2021-rcpch.459

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