Journal
JOURNAL OF PEDIATRICS
Volume 242, Issue -, Pages 32-+Publisher
MOSBY-ELSEVIER
DOI: 10.1016/j.jpeds.2021.11.024
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Funding
- Arvid Nilsson's [1780631]
- Danish Childhood Cancer Foundation [2017-1945]
- Olufgard Memorial Fund [25734]
- Aarhus University
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This study found that 7% of children with cancer had a musculoskeletal diagnosis within 6 months before the cancer diagnosis, but this did not affect their overall survival.
Objective To identify the prevalence of musculoskeletal diagnoses recorded 6 months before the diagnosis of cancer and to evaluate whether preceding musculoskeletal diagnoses affected survival. Study design We performed a nationwide registry-based cohort study including all children under 15 years of age diagnosed with cancer in Denmark over a 23-year period (1996-2018). The Danish National Patient Registry was used to identify musculoskeletal diagnoses and associated dates recorded within 6 months preceding the diagnosis of cancer. We compared the characteristics of children with and without a prior musculoskeletal diagnoses using prevalence ratios and 95% CI and diagnostic interval as median with IQR. We compared survival using Kaplan-Meier and Cox proportional hazards regression analysis adjusting for age, sex, and presence of metastasis at diagnosis. Results Of 3895 children with all types of cancer, 264 (7%) had a total of 451 hospital visits with musculoskeletal diagnosis within 6 months preceding the diagnosis of cancer; however, survival was not affected. The overall median diagnostic interval from first musculoskeletal diagnosis (within 6 months before cancer diagnosis) to cancer diagnosis was 15 days (IQR, 7-47 days). A diagnosis of juvenile idiopathic arthritis, unspecified arthritis, and arthropathy each accounted for 5% of the contacts, primarily in children with acute lymphoblastic leukemia, bone sarcomas, or neuroblastomas. Conclusions A preliminary musculoskeletal diagnosis occurred in 7% of children with cancer, but did not affect the overall survival.
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