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Mass screening and age-specific incidence of neuroblastoma in Saitama Prefecture, Japan
K Yamamoto1, Y Hayashi, R Hanada
1Division of Hematology/Oncology, Saitama Children's Medical Center, Japan.
Insights
Mass screening for neuroblastoma in infants led to a sharp increase in incidence rates, particularly for those under one year old. This suggests screening detects tumors that might not have been clinically diagnosed later.
Area of Science:
- Pediatric Oncology
- Epidemiology
- Cancer Screening
Background:
- Neuroblastoma is a common childhood cancer.
- Mass screening aims to detect cancers early.
- The impact of mass screening on neuroblastoma incidence requires evaluation.
Purpose of the Study:
- To determine the population-based incidence rate of neuroblastoma.
- To assess the effect of mass screening on age-specific incidence in Saitama Prefecture, Japan (1981-1992).
Main Methods:
- Utilized data from screening centers, Children's Cancer Registry (Prefectural and National).
- Population data sourced from the Prefectural Census.
- Mass screening involved urinary vanillylmandelic acid (VMA) testing (qualitative and quantitative VMA/creatinine and homovanillic acid/creatinine).
Main Results:
- Identified 199 neuroblastoma cases (74 by screening) between 1981-1992.
- Incidence rates increased significantly: under 15 years (6.4 to 20.1/10^6), 0-4 years (17.0 to 64.1/10^6), and infants under 1 year (27.9 to 260.4/10^6).
- No significant reduction in incidence was observed for children over 1 year of age.
Conclusions:
- Mass screening correlated with increased neuroblastoma incidence rates, especially in infants.
- The data suggest screening detects a subset of neuroblastoma that may not be clinically diagnosed later.
- Further research is needed to understand the clinical significance of screen-detected neuroblastomas.
Purpose:
To provide the population-based incidence rate of neuroblastoma and to determine the effect of mass screening on the annual age-specific incidence of the tumor in Saitama Prefecture, Japan, from 1981 to 1992.
Methods:
Data on screened infants and patients detected by the screening were obtained from the records of the Prefectural Screening Center. Data on neuroblastomas in this area were obtained from the Children's Cancer Registry of the Saitama Prefectural Government (Prefectural Registry) and from the Japan Children's Cancer Registry (National Registry). Population data were obtained from the Prefectural Census. Mass screening for 6-month-old infants was performed by qualitative assessment of urinary vanillylmandelic acid (VMA) from June 1981 to September 1989 and by quantitative measurement of VMA/creatinine (Cre) and homovanillic acid (HVA)/Cre from October 1989 to December 1992.
Results:
Between 1981 and 1992, 199 cases of neuroblastoma, which include 74 cases detected by mass screening, were identified in Saitama Prefecture. The incidence rate for children under 15 years of age increased from 6.4/10(6) to 20.1/10(6), that for children 0 to 4 years of age increased from 17.0/10(6) to 64.1/10(6), and that for infants under 1 year of age increased from 27.9/10(6) to 260.4/10(6) during these 12 years. No significant reduction in the incidence rate was observed for children over 1 year of age.
Conclusion:
The incidence rate for children under 15 years of age increased with mass screening. The rate for infants was sharply increased, with no corresponding decrease in the rate for children at older ages. These data suggest that there is a subset of neuroblastoma that can be detected by mass screening at 6 months of age but would not be diagnosed later clinically.