In pursue of early diagnosis of childhood cancer: Mapping children’s pathways in primary care and the role of socioeconomic factors, family adversity, calendar period, and biomarkers

In Sweden, cancer is the no. 1 killer in childhood and adolescence, with large socioeconomic disparities in survival. Early diagnosis saves lives, but data on the pre-diagnostic period spent in primary care is lacking.

My goal is to answer these questions: (a) What are the pre-diagnostic pathways of children with cancer in primary care and are there delays in referral linked to parental socioeconomic background and adversity, calendar period and region? (b) Which diagnoses and biomarkers in primary care facilitate early referral for childhood cancer diagnosis?To answer these research questions, I will conduct epidemiologic studies leveraging a linkage of nationwide health and sociodemographic registers, a cancer quality register, and primary care databases from Stockholm, Västra Götaland, and Skåne that are readily available for research.

I will obtain data on primary care visits, waiting and referral times, and biomarkers during the pre-diagnostic period for childhood cancer cases, general population controls, and siblings, and determine family socioeconomic indicators and childhood adversity.

Data will be analyzed using modern statistical methods and machine-learning algorithms.Childhood cancer is a major cause of suffering in childhood and survival has not improved for years, especially for the most deprived.

Through standardizing clinical pathways in primary care and tackling delays in referral, early diagnosis of childhood cancers will provide children with better prospects of survival and healthy growth irrespective of socioeconomic status and place of residence.