Child Health Book: Enhancing Early Diagnosis of Pediatric Central Nervous System Tumors in an Upper-Middle-Income Country

Abstract To assess the use of the Child Health Book (CHB, Caderneta de Saúde da Criança, in Portuguese)—Brazil's standard instrument for comprehensive pediatric health surveillance—by parents and healthcare professionals, and to evaluate the potential and acceptability of adding childhood cancer information as a strategy to improve timely diagnosis, with particular focus on central nervous system (CNS) tumors, the leading cause of cancer-related morbidity and mortality in children. This is a cross-sectional study. Data were collected through interviews and virtual questionnaires with participants from primary and tertiary care settings randomly selected from those available during the study period, including parents of children with and without cancer diagnoses (CNS tumors), and healthcare professionals from both care levels. Between August and November 2023, 200 parents of children cared for in The Pediatrics and Oncology Departments of Universidade Federal de São Paulo and 147 healthcare professionals from primary and tertiary care participated. Most parents of children cared for in the pediatrics (88%) and oncology (91%) departments used the CHB, with more than 75% supporting the inclusion of childhood cancer information with particular focus on CNS tumors. Among professionals, CHB use was reported by 94.7% in primary care and by 77.4% in tertiary care, with most recommending parents engage with its content. The professionals overwhelmingly supported adding childhood cancer information to the CHB. The CHB is a widely accessible resource for parents and healthcare professionals. The study demonstrates the feasibility and acceptability of incorporating a practical framework for the recognition of warning signs and symptoms of CNS tumors and other childhood cancers into the CHB, facilitating timely surveillance during routine care and potentially reducing morbidity and mortality among children with cancer. Prospective studies are needed to evaluate the impact of such an intervention on diagnostic intervals and clinical outcomes.