Seasonal Variation in the Diagnosis of Retinoblastoma

Shonar Singh, Thamanna Nishath, Ido Didi Fabian, Xiudi Li, Megan Othus, Mai Tzukikawa, Andrew W. Stacey

Research output: Contribution to journalArticlepeer-review


Purpose: To determine the seasonal variation in the diagnosis of retinoblastoma in a global sample of children and to investigate predictors of seasonal trends. Methods: Data were collected through a global, multicenter, 1-year cross-sectional analysis that included all treatment- naïve retinoblastoma patients presenting to participating centers between January 1, 2017, and December 31, 2017. Due to variations in days per month, data were normalized to a 30-day/month calendar. Observed data were compared to a simulation study of expected results using a uniform distribution. Results: Patient-level data were available for 4,351 children from 276 centers in 153 countries, of which 3,966 had a month of presentation recorded. There were relative peaks in disease presentation in January and July, with lower counts in November and December (p = .0015). No covariates were found to be significantly associated with the seasonal trend. Two covariates, patient age at presentation and extraocular tumor spread, showed a moderate association with month of presentation. Conclusion: Our findings suggest seasonal trends in the presentation of retinoblastoma across the world. However, these trends do not appear to be related to income level of a country, climate, or other covariates. Any connection between seasonal variation of retinoblastoma presentation and retinoblastoma outcomes remains unclear or not present.

Original languageEnglish (US)
Pages (from-to)509-514
Number of pages6
JournalOphthalmic Epidemiology
Issue number5
StatePublished - 2023
Externally publishedYes


  • Intraocular tumor in children
  • Retinoblastoma
  • Seasonal variations of cancer
  • Seasonality of retinoblastoma

ASJC Scopus subject areas

  • Ophthalmology
  • Epidemiology


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