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Mass screening of neuroblastoma in infancy
Insights
A vanillylmandelic acid spot test effectively screened over 78,000 infants for neuroblastoma, discovering four cases. This early detection method for infant neuroblastoma proved cost-effective and successful in identifying the disease.
Area of Science:
- Pediatric Oncology
- Biochemical Screening
- Public Health
Background:
- Neuroblastoma is a common childhood cancer.
- Early detection of neuroblastoma improves treatment outcomes.
- Screening methods are crucial for identifying asymptomatic cases.
Purpose of the Study:
- To evaluate the efficacy of a vanillylmandelic acid (VMA) spot test for mass screening of infants for neuroblastoma.
- To assess the feasibility and cost-effectiveness of implementing this screening program.
Main Methods:
- A collaborative screening program involving 11 health centers in Kyoto, Japan.
- Urine samples from 78,331 infants aged 6-7 months were collected on filter paper.
- Analysis of VMA levels in urine to detect potential neuroblastoma.
Main Results:
- Four asymptomatic infants with neuroblastoma were identified among 78,331 screened.
- Three of the diagnosed infants successfully completed treatment and recovered.
- The screening program cost approximately $7,500 per 13,000 infants screened annually.
- One false-negative and several false-positive results were noted.
Conclusions:
- The VMA spot test is a viable and cost-effective method for early neuroblastoma detection in infants.
- Mass screening can lead to the discovery of asymptomatic neuroblastoma cases.
- Further refinement may be needed to address false-positive and false-negative rates.
Abstract:
A vanillylmandelic acid spot test for screening infants for neuroblastoma was developed in cooperation with 11 health centers in Kyoto, Japan. In this system, the parent sends a filter paper spotted with the infant's urine at 6 or 7 months of age. From 78,331 infants screened during the six years from July 1973 to September 1979, four asymptomatic infants with neuroblastoma were discovered. Three of them have already completed their treatments and have recovered. The cost of screening 13,000 infants per year was $7,500. One false-negative test was encountered, as were a number of false-positive tests.