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Updated: Jul 10, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Is the mass screening for neuroblastoma ineffective?

M Nishi1, J Hanai, K Fujita

  • 1Dept. of Fundamental Health Sciences, Health Sciences University of Hokkaido, Hokkaido, Japan.

Journal of Experimental & Clinical Cancer Research : CR
|April 1, 2004
PubMed
Summary

Mass screening for neuroblastoma in 12-month-old children is effective, despite previous claims. Reanalysis of data reveals significant underestimation of effectiveness due to flawed control groups and calculation methods.

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Area of Science:

  • Pediatric Oncology
  • Screening Program Evaluation

Background:

  • A recent study by Schilling et al. (2002) questioned the effectiveness of mass screening for neuroblastoma in 12-month-old children.
  • This reevaluation addresses methodological issues in the original study that may have led to an inaccurate conclusion.

Purpose of the Study:

  • To reestimate the effectiveness of mass screening for neuroblastoma in 12-month-old children using data from Schilling et al. (2002).
  • To identify and correct for biases in the original study's methodology.

Main Methods:

  • Utilized data from Schilling et al. (2002), comparing "control area" subjects with "non-participants" for bias assessment.
  • Reanalyzed the calculation of the "screened group" incidence by separating false negatives and true positives.
  • Compared stage 4 neuroblastoma incidence and mortality between false negatives and non-participants.

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Main Results:

  • The use of "control area" subjects as controls underestimated screening effectiveness by approximately 25%.
  • Combining false negatives and true positives inflated "screened group" incidence, further underestimating effectiveness.
  • Stage 4 neuroblastoma incidence was 40% lower in non-participants compared to false negatives, with lower mortality.
  • An estimated 40% of true positives represent spontaneous regression cases.

Conclusions:

  • The mass screening for neuroblastoma targeting 12-month-old children demonstrates effectiveness when analyzed with corrected methodologies.
  • The revised findings suggest better outcomes than Japanese screening programs, supporting the value of this screening approach.