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Mass screening in Japan increased the detection of infants with neuroblastoma without a decrease in cases in older
F Bessho1, K Hashizume, T Nakajo
1Operation Office of Kanto-Ko-Shin-Etsu Branch, Japan Children's Cancer Registry, Tokyo.
Insights
Mass screening for neuroblastoma significantly increased infant case detection and the proportion of pediatric cancers. However, it likely identified unique tumors rather than enabling earlier diagnosis in older children.
Area of Science:
- Pediatric Oncology
- Cancer Epidemiology
- Public Health Screening
Background:
- Neuroblastoma is a significant childhood cancer.
- Early detection strategies are crucial for improving outcomes.
- The impact of mass screening on neuroblastoma detection requires evaluation.
Purpose of the Study:
- To assess the effect of mass screening on neuroblastoma detection rates in infants.
- To determine if mass screening alters the overall proportion of neuroblastoma among pediatric cancers.
- To investigate whether screening identifies unique tumor types or facilitates earlier diagnosis.
Main Methods:
- Analysis of data from the Japan Children's Cancer Registry (Kanto-Ko-Shin-Etsu Branch).
- Comparison of neuroblastoma detection rates and proportions before and after the implementation of mass screening.
- Statistical analysis to differentiate between screening-detected and clinically diagnosed cases.
Main Results:
- Mass screening for neuroblastoma increased detection in infants under 1 year from 25% to 50%.
- The proportion of neuroblastomas among all pediatric cancers nearly doubled, from 10% to 19.3%.
- Excluding screening-detected cases, the number of diagnosed neuroblastomas remained similar before and after screening implementation.
Conclusions:
- Neuroblastoma mass screening appears to identify a distinct tumor subset not typically diagnosed through clinical presentation alone.
- The findings suggest screening identifies a unique biological entity rather than solely facilitating earlier diagnosis of common neuroblastoma types.
- Further research is needed to understand the clinical and biological implications of screening-detected neuroblastomas.
Abstract:
Analysis of data from the Kanto-Ko-Shin-Etsu Branch of the Japan Children's Cancer Registry revealed that mass screening for neuroblastoma increased the detection of cases in infants younger than 1 year from about 25% before screening to about 50%, and the percentage of neuroblastomas among all pediatric cancers almost doubled, from approximately 10% to 19.3%. However, when the cases found on screening were subtracted, the numbers after the onset of mass screening were similar to those before screening. It is likely that neuroblastoma mass screening has identified a unique type of tumor, which may not be recognized without mass screening, rather than that it has contributed to the earlier diagnosis of tumors in older children.