Retinoblastoma stage at diagnosis varies by country income

  • Fabian ID & al.
  • JAMA Oncol
  • 27 Feb 2020

  • curated by Emily Willingham, PhD
  • Clinical Essentials
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Takeaway

  • Compared with children from high-income countries (HICs), those from low/middle-income countries (LMICs) far more often have extraocular tumors at retinoblastoma diagnosis.
  • This feature is present in 49.1% of children from low-income countries (LICs) vs 1.5% from HICs.

Why this matters

  • LMICs are where most retinoblastomas are diagnosed.
  • This disease is curable if diagnosed early enough.

Key results

  • Median age at diagnosis was 23.5 (interquartile range [IQR], 11.2-36.5) months.
  • Patients from HICs were diagnosed at a median age of 14.0 (IQR, 6.2-26.6) months.
  • Patients from LICs were diagnosed at a median age of 30.5 (IQR, 18.3-45.9) months.
  • Children from LMICs made up the vast majority (84.7%) of the cohort.
  • 98.5% of children from HICs had intraocular disease at diagnosis.
  • 49.1% of children from LICs had extraocular disease, and 18.9% had metastases.

Study design

  • Included 4351 patients from 278 treatment centers in 153 countries.
  • Funding: Queen Elizabeth Diamond Jubilee Trust.

Limitations

  • Biases associated with a convenience sample.
  • Largely retrospective data.