Biochemical screening for neuroblastoma in infants: a feasibility study

Neuroblastoma is the most common solid tumour of childhood with an incidence of about 1:10,000 births. Prognosis depends on age and stage at presentation and for disseminated disease presenting after the age of 1 year has scarcely altered at all in the past 20 years. In Japan a method has been pioneered of mass population screening of 6-month-old babies using a urine test for the catecholamine metabolites vanillylmandelic acid and homovanillic acid. They have been able to detect the majority of cases at 6 months and have improved the overall prognosis from 25% to 75% survival. A pilot study to assess the feasibility of such a study in the UK has been carried out in the north of England. Methodology has been established for the collection of urine by health visitors and biochemical analysis by gas chromatography with both flame ionisation and mass spectrometry detection; 4,897 samples have been collected, and reference ranges have been established.