A global survey of health care providers (HCPs) revealed significant knowledge gaps about childhood central nervous system (CNS) tumors, according to a presentation at the 20th International Symposium on Pediatric Neuro-Oncology (ISPNO).

Investigators at St Jude Children’s Research Hospital conducted a cross-sectional survey to evaluate HCP knowledge of CNS tumors.

The researchers distributed a questionnaire to HCPs via email between November 2018 and March 2020. The questionnaire focused on symptoms, signs, and imaging indications of CNS tumors. Participants responded to the questionnaire prior to and following an educational seminar on CNS tumors.

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A total of 889 pre-tests and 392 post-tests were completed. Pre- and post-test responders were from Asia (73.1% vs 87.5%), Latin America (18.5% vs 6.5%), the Middle East (5.2% vs 4.3%), Eurasia (1.9% vs 1.1%), Africa (0.8% vs 0.3%), and Europe (0.5% vs 0.3%).

The pre- and post-tests were completed by pediatricians (43.1% vs 20.6%), medical students (26.9% vs 47.7%), and residents (21.1% vs 28.3%). Most pre-test (66.4%) and post-test (89.9%) respondents had 0-5 years of clinical working experience.

The median score was 40.0% (range, 13.1%-92.9%) for the pre-tests and 77.1% (range, 14.9%-98.2%) for the post-tests.

In the pre-tests, few HCPs knew that Cushing’s triad was a less common symptom (18.7%) or recognized that children older than 10 years of age are at risk of late diagnosis (15.0%).

More than half of respondents (54.5%) incorrectly identified medulloblastoma as the most common CNS tumor. Less than half (47.7%) were aware that parents were better than HCPs at suspecting a clinical manifestation was associated with a CNS tumor.

In the post-tests, 94.9% of respondents correctly identified low-grade glioma as the most common childhood CNS tumor, but 32.2% of respondents still incorrectly thought that children 3 years of age or younger were at risk of delayed diagnosis.

Most respondents (62.8%) correctly recognized Cushing’s triad as a less common symptom, but only 14.9% accurately identified torticollis as the least common diagnosis.

By HCP specialty, pediatricians had the worst scores on pre- and post-tests (both P <.05). However, the researchers found no significant difference in knowledge scores on the basis of years of clinical experience, number of cases diagnosed, or geographic region.

This survey suggests that many HCPs may have gaps in their knowledge of childhood CNS tumors. The researchers suggested targeted education during undergraduate, residency, nursing, and postgraduate programs as well as identifying effective referral pathways in the healthcare system as potential areas for improvement.


Rajagopal R, Moreira DC, Faughnan L, et al. Knowledge gap among health care providers in childhood central nervous system tumors: Result from an international multicenter survey. Presented at ISPNO 2022; June 12-15, 2022. Abstract OTHR-06.