Use of healthcare services and prescription medication prior to sarcoma diagnosis in children, adolescents, and young adults in 1997-2020: a population-based cohort study.
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PURPOSE: Sarcomas are among the leading causes of cancer death in children, adolescents, and young adults and survival has not been substantially improved for decades. Reducing the diagnostic interval could contribute meaningfully to increased survival at a low- cost. This study provided much-needed knowledge of the prediagnostic patient trajectories to direct future clinical efforts. METHODS: This population-based study examined the use of healthcare services in the two years preceding diagnosis in 1524 children, adolescents, and young adults with sarcoma compared to the background population, based on Danish national register data from 1997 to 2020. RESULTS: Sarcoma patients were more likely than the background population to have contacts in the primary healthcare sector, hospital outpatient clinics, and emergency rooms, and to fill prescriptions for pain- and antimicrobial medication for up to 24 consecutive months before diagnosis. Patients with metastatic sarcoma at the time of diagnosis were more likely than non-metastatic patients to use healthcare services in the last 2-4 months prior to diagnosis. CONCLUSION: Reducing the diagnostic interval in early-life sarcomas should be explored as a low-cost complement to new, advanced treatments to improve survival. Efforts should focus on improving the selection of CAYA with musculoskeletal symptoms for early referral and a better understanding of the diagnostic pathway within the secondary healthcare system.