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Mass screening of neuroblastoma in Sapporo City, Japan
Insights
Mass screening for neuroblastoma in infants significantly improved early detection and survival rates. Introducing a second screening aims to further reduce missed cases, enhancing childhood cancer outcomes.
Area of Science:
- Pediatric Oncology
- Public Health Screening Programs
- Cancer Epidemiology
Background:
- Neuroblastoma is a common childhood cancer.
- Early detection is crucial for improving patient outcomes.
- Mass screening programs can identify cancers in asymptomatic infants.
Purpose of the Study:
- To evaluate the effectiveness of a mass screening program for neuroblastoma in infants.
- To assess the impact of screening on clinical stage, age at diagnosis, and survival rates.
- To determine the benefit of implementing a second screening examination.
Main Methods:
- A 9-year mass screening program for neuroblastoma in 6-month-old infants in Sapporo City.
- Screening involved urine tests to detect neuroblastoma.
- Comparison of outcomes between screened and unscreened neuroblastoma cases.
Main Results:
- Over 136,000 infants were screened, detecting 26 true-positive and 6 false-negative neuroblastoma cases.
- Screened patients had more favorable clinical stages, earlier diagnosis, and better survival rates.
- A significant decrease in advanced-stage neuroblastoma and mortality in children under 4 was observed post-screening implementation.
Conclusions:
- Infant mass screening for neuroblastoma is effective in improving early detection and survival.
- Implementing a second screening at 14 months of age is expected to further reduce missed diagnoses.
- Mass screening programs contribute to a reduction in childhood cancer mortality.
Abstract:
In Sapporo City a mass screening program for neuroblastoma aiming at 6-month-old infants has been performed since April 1981. By March 1990, 136,001 infants were screened; 26 true-positive cases of neuroblastoma and six false-negative cases were detected. The sensitivity of the mass screening method was about 80% throughout the 9 years. During the 9-year period, a total of nine children with neuroblastoma who were not screened were also identified. Clinical stage, age at diagnosis, and survival rate for the 32 patients who were screened (26 true positives and six false negatives) were much more favorable than those for the nine patients who were not screened. A remarkable decrease in the incidence of cases of neuroblastoma with advanced clinical stages over 1 year of age, especially among children 1-4 years of age, was noted after the start of the mass screening. The mortality from this tumor in children up to 4 years of age significantly decreased after the start of the urinary screening program. Rescreening at 14 months of age was begun in April, 1991 in Sapporo City. Performing two screening examinations decreases the probability of overlooking a patient. Thus, it is expected that tumors missed on the first screening would be detected by the second screening.
