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Background  Despite advances in the field of pediatric oncology, cancer remains a leading cause of death in children. The delays in cancer diagnosis may occur throughout the diagnostic pathway. Diagnosis of childhood cancer as early as possible is crucial to reduce mortality. The aim of this study was to identify determinants of delayed diagnosis among pediatric cancer patients in Ayder Comprehensive Specialized Hospital, Northern Ethiopia.    Method  Facility based cross-sectional study was conducted among pediatric cancer patients aged less than 18 years. Data collection was done by interviewer-administered structured questionnaire from the volunteer primary caregiver from 1st September 2017 to 30th August 2018. The data was checked and cleaned by principal investigator on daily basis during data collection for completeness, consistencies, then coded, entered and analyzed using SPSS version 21 software. Diagnosis delay was considered significant when it is above the 3rd quartile. Binary logistic regression analysis was used to test associations between each of the determinant factors and the dependent variable. Variables with  P -value < 0.25 during bivariate analysis were fed to the multivariate logistic regression model. Finally, variables with  P -value < 0.05 were considered as determinants of delayed diagnosis.    Results  From a total of 102 patients, 71(69.6%) had delayed diagnosis. Children older than 10 years of age were four (AOR = 4.01; 95%CI = 1.55–12,  P  < 0.001) times more likely to get delayed compared to under five children. Rural residence (AOR = 3.3; 95%CI = 1.24–10.24,  P  < 0.001), uneducated parents (AOR = 3.4; 95%CI = 1.91–13.25,  P  = 0.009), parents with monthly income less than 1000 ETB (AOR = 6.1; 95%CI = 1.76–7.23,  P  < 0.001), absence of health insurance (AOR = 2.4; 95%CI = 1.50–3.50,  P  = 0.02), visit to holy water (AOR = 3.4;95%CI = 1.6–7.2) and those who think cancer is incurable (AOR = 2.7;95%CI = 1.3–14, P  = 0.004) were also likely to be delayed.    Conclusion  Delayed diagnosis of childhood cancer was a major issue and most influenced by the child’s age, residency, family’s socioeconomic status, parental education, health insurance, use of holy water and caregivers perception on curability of cancer. Thus; every effort should be made to promote public and parental awareness of childhood cancer and promoting health insurance.

Determinants of delayed diagnosis among pediatric cancer patients from Ayder Comprehensive Specialized Hospital, Mekelle, Northern Ethiopia