Screening for neuroblastoma in infants younger than 1 year of age: review of the first 30 years

Abstract

Background Mass population screening of infants for neuroblastoma was introduced in Japan in 1985. Other investigations of screening have been carried out in North America and Europe. Procedure This paper summarizes the epidemiological results from the reports published from the infant screening programs in Japan, North America, and Europe. Exceptionally, for Germany, data presented in abstracts at specialist conferences are reported, as little information is available in the published literature. Results Compliance with infant screening is in excess of 80% in Japan, North America, and Europe, with the exception of Austria, where compliance has been as low as 30%. The detection rate for nonquantitative biochemical screening methods was variable, while that for high‐pressure liquid chromatography (HPLC), the current method of choice, was around 22 per 100,000 at most centers. All programs resulted in an increased incidence rate indicative of the detection (and hence subsequent treatment) of children with neuroblastoma, which would otherwise have regressed spontaneously. Case survival for cases detected by screening is high (>90%), but all programs are also associated with false‐negative cases, which tend to have a poor outcome. Conclusions. Screening at 6 months of age is accompanied by an increased incidence of disease as a consequence of detection of neuroblastoma which would otherwise regress. These children are consequently overtreated. Overall, with high mortality in the false‐negative cases the possible benefit of screening on mortality is necessarily small and has not yet been demonstrated in reliable data. Thus, overall it is doubtful whether screening at 6 months of age confers sufficient advantage to children with neuroblastoma, and its continued practice cannot be recommended. Med. Pediatr. Oncol. 31:455–469, 1998. © 1998 Wiley‐Liss, Inc.

Frequency of cancer in children residing in Mexico City and treated in the hospitals of the Instituto Mexicano del Seguro Social (1996–2001)

“…This finding is one that should be followed up because there are two factors that would have affect the reported number of cases and, hence the frequency: Because Mexico does not have the screening programs for detecting children with neuroblastoma that other countries do [25], it was probable that cases of this disease were not being diagnosed. Also, it is known that some of these tumors do regress spontaneously [26].…”

Massive Hepatomegaly With Respiratory Distress in a Newborn

“…2 It is a family of heterogeneous tumors of the sympathetic nervous system arising from cells of neural-crest origin, with primary sites in the adrenal gland, abdominal, thoracic, cervical, and pelvic ganglia. 4 Neuroblastoma stage 4S tumors are well known to regress without treatment, with current guidelines recommending minimal treatment/only observation. 4 Neuroblastoma stage 4S tumors are well known to regress without treatment, with current guidelines recommending minimal treatment/only observation.…”

A systematic review and evaluation of the use of tumour markers in paediatric oncology: Ewing's sarcoma and neuroblastoma

“…93 The case for screening revolves around the evidence that neuroblastoma is a disease of early childhood, with the majority of patients presenting with advanced stage disease and having a poor prognosis, and some suggestion that the disease could progress from localised good prognosis disease to advanced stage disease, linked with the easy availability of urine tumour metabolites for screening. As a consequence, large screening programmes were established in Japan, North America and Europe.…”