Referral Patterns, Time-To-Diagnosis (TTD), and Time-To-Treatment Initiation (TTI) in Children with Cancer: Experience from a Tertiary Care Center, King Faisal Specialist Hospital & Research Centre (KFSH&RC), Madinah, Saudi Arabia

Introduction: Timely access to tertiary care centers can positively impact outcomes in childhood cancer.Delayed access or unavailability of services impacts referral time, diagnosis, and therapy initiation. Methodology:We conducted a retrospective EMR review of referral patterns, TTD, and TTI in children with cancer seen over two years at our center.Results: 118 (92%) patients out of 129 total referrals analyzed were treatment nave, of which 11 (8%) were referred to continue therapy; first-line (7) or second-line (4).89% (115) of referrals were from the Western Region.The median age at diagnosis was 6.3 years (0.19 -13.9) with 66 (51%) females and 63 (49%) males.The most common cancer diagnoses were leukemia, 70 (59%), solid tumors, 34 (29%), and lymphomas, 14 (12%).Median time from the onset of symptoms to a visit to a health center was 15 days (1 -177).Referral to a tertiary care center was 2 (1 -47) days.All cases were accepted within 24 hours from the referral time.Median time to first encounter with an oncologist was 2 days (1 -5).Median time for diagnostic biopsy after the first visit was 3 days (1 -22) and TTD was 3 days (2 -29).The median duration of TTI was 4 days (1 to 13) for all patients.A significant difference in referral patterns, TTD, and TTI when compared by gender, age, and cancer diagnosis was not seen. Conclusion:Early access to a regional Childhood Cancer Center reduces patient waiting time for diagnosis and therapy initiation and contributes to favorable outcomes.