Mass screening for neuroblastoma and estimation of costs

On the basis of epidemiological data and medical costs for patients with neuroblastoma, we have calculated the cost of mass screening for neuroblastoma with high performance liquid chromatography (HPLC) compared to the cost when it is not performed. If the sensitivity of the mass screening is 80% and 22,000 infants are screened annually the cost will be 27,809,000 yen ($191,800). If mass is not performed, the cost will be 28,446,000 yen ($196,200). The difference in cost (637,000 yen or $4,400) is fairly small. If the sensitivity is 75% and 16,500 infants are screened, the difference is also small (174,000 yen or $1,200). Therefore, mass screening with the HPLC method will not be an undue financial burden. But re-screening at an older age will be done with less financially favorable results, considering that the sensitivity may not be as high as that of the first screening and that mothers are somewhat reluctant about re-screening. The balance of the cost of mass screening by qualitative methods may also be less favorable, since the detection rate is low.