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Related Experiment Videos

Is neuroblastoma screening evaluation needed and feasible?

J Estève1, L Parker, P Roy

  • 1International Agency for Research on Cancer, Lyon, France.

British Journal of Cancer
|June 1, 1995
PubMed
Summary

Screening children for neuroblastoma (a childhood cancer) may not be beneficial due to overdiagnosis. Later screening ages might reduce mortality with less overdiagnosis, but large trials are needed to confirm efficacy.

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Area of Science:

  • Pediatric Oncology
  • Medical Screening
  • Public Health

Background:

  • Neuroblastoma screening in Japan has involved over five million children.
  • The benefit of widespread neuroblastoma screening remains uncertain.
  • Early screening (at 6 months or younger) has been linked to significant overdiagnosis.

Purpose of the Study:

  • To evaluate the efficacy of later-age neuroblastoma screening.
  • To determine if adjusted screening protocols can reduce mortality with less overdiagnosis.
  • To estimate the required scale for a definitive screening efficacy trial.

Main Methods:

  • Modeling the impact of different screening ages on neuroblastoma mortality and overdiagnosis.
  • Estimating the reduction in mortality achievable with two screens at 12 and 18 months.

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  • Calculating the sample size and duration needed for a prospective screening trial.

    • Main Results:

    • Screening at later ages (e.g., 12 and 18 months) may offer similar mortality reduction to earlier screening but with potentially less overdiagnosis.
    • Even with optimized screening schedules, mortality reduction is estimated to not significantly exceed 25% under realistic assumptions.
    • A large-scale trial requires recruiting 500,000 children annually for 5-7 years, plus an equal number of controls.

    Conclusions:

    • Current neuroblastoma screening strategies, particularly early screening, lead to substantial overdiagnosis.
    • Later-age screening warrants further investigation, but significant mortality reduction may be limited.
    • Future research should focus on large, well-designed trials to clarify screening benefits and understand neuroblastoma's biological heterogeneity.