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Mass screening for neuroblastoma and mortality in birth cohorts
1Department of Public Health, Sapporo Medical University, Hokkaido, Japan.
Insights
High-performance liquid chromatography (HPLC) mass screening for neuroblastoma in infants significantly reduced mortality by 69% in Sapporo City. This early detection method shows promise for improving treatment outcomes in young children.
Area of Science:
- Pediatric Oncology
- Public Health Screening Programs
- Biochemical Analysis
Background:
- Neuroblastoma is a significant cause of mortality in infants.
- Early detection and intervention are crucial for improving neuroblastoma patient outcomes.
- Assessing the impact of novel screening technologies on disease-specific mortality is essential.
Purpose of the Study:
- To evaluate the effectiveness of a high-performance liquid chromatography (HPLC) mass screening program for neuroblastoma.
- To compare mortality rates in HPLC-screened and non-HPLC-screened infant cohorts.
- To analyze the impact of HPLC screening on neuroblastoma incidence and mortality across different age groups.
Main Methods:
- Investigated mortality data from neuroblastoma birth cohorts in Sapporo City and Japan.
- Compared mortality rates between pre-screening, non-HPLC screened, and HPLC screened cohorts.
- Analyzed neuroblastoma incidence in infants and children aged 1-4 years in relation to screening status.
Main Results:
- In Sapporo City, the HPLC-screened cohort showed a 69% reduction in neuroblastoma mortality compared to the pre-screening cohort.
- Nation-wide, non-HPLC screened cohorts also showed a decline in mortality.
- The HPLC cohort in Sapporo experienced a halving of neuroblastoma incidence at 1-4 years, potentially linked to increased infant detection.
Conclusions:
- HPLC mass screening for neuroblastoma in infants is associated with a significant reduction in mortality.
- Early detection of neuroblastoma through HPLC screening may identify high-risk cases amenable to more effective therapy.
- The findings support the implementation and further investigation of HPLC screening programs for neuroblastoma.
Abstract:
Mortality resulting from neuroblastoma in birth cohorts in both Sapporo City and the whole of Japan was investigated to evaluate the effects of a high-performance liquid chromatography (HPLC) mass screening program, targeting on 6 month-old infants. In Sapporo City, the non-HPLC screened cohort showed no reduction in mortality at 4 years of age compared with the pre-screening cohort. However, the HPLC screened cohort showed a reduction of 69% in mortality compared with the pre-screening cohort. On a nation-wide scale, there was a significant decline in mortality for the non-HPLC screened cohort compared with the pre-screening cohort; for the HPLC screened cohort for 1989-1991, there was also a reduction in mortality for children younger than 2 years of age. The incidence of neuroblastoma at 1-4 years of age in the HPLC cohort in Sapporo City was about half that in the pre-screening cohort, along with and probably because of an increasing incidence among infants in the same cohort. Our findings suggest that HPLC screening may detect some poor-prognosis neuroblastoma cases at early stages, thus providing for more favorable therapy.