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Mass screening for neuroblastoma targeting children age 14 months in Sapporo City: a preliminary report
Insights
A 14-month mass screening for neuroblastoma in Sapporo identified more cases than expected, including those missed by the 6-month screening. This program effectively detects neuroblastoma in young children.
Area of Science:
- Pediatric Oncology
- Public Health Screening
- Cancer Epidemiology
Background:
- Sapporo City implemented a mass screening program for neuroblastoma in children at 6 months of age in 1981.
- An additional screening program targeting 14-month-old children was introduced in April 1991.
Purpose of the Study:
- To evaluate the effectiveness of a 14-month mass screening program for neuroblastoma.
- To identify neuroblastoma cases missed by the existing 6-month screening program.
Main Methods:
- High-performance liquid chromatography (HPLC) was utilized for the 14-month screening.
- Case identification relied on the Registry of Childhood Malignancies in Hokkaido Prefecture.
Main Results:
- The 14-month screening (14-MS) had a 65.8% compliance rate, with 56,444 children participating out of 85,783 live births (1990-1994).
- Among children previously screened at 6 months, 6 neuroblastoma cases were detected by 14-MS, with one additional clinical diagnosis after a negative screen.
- Two more cases were found in children not participating in the 6-month screen, indicating a higher-than-expected incidence.
Conclusions:
- The 14-month mass screening effectively detects neuroblastoma cases missed or not screened at 6 months.
- The observed detection rate by the 14-month screening exceeds the expected natural incidence of neuroblastoma.
Background:
In Sapporo City a mass screening program for neuroblastoma targeting children age 6 months (6-MS) was initially introduced in 1981. Since April 1991, an additional program has been implemented, aimed at children age 14 months (14-MS).
Methods:
High performance liquid chromatography was employed in the 14-MS. Identification of cases was dependent on the Registry of Childhood Malignancies in the Hokkaido Prefecture.
Results:
Of the 85,783 live births in Sapporo City during the period 1990-1994, a total of 56,444 participated in the 14-MS (compliance rate, 65.8%). By the end of 1996, of 48,448 children who had previously taken part in the 6-MS, 6 cases were identified in the 14-MS, and 1 additional case screened negative but was later diagnosed clinically. Two more cases were detected in the 14-MS among the 7996 children who had not participated in the 6-MS. Though the incidence of cases identified by the 14-MS was much higher than expected, several true-positive cases had unfavorable histology (as defined by Shimada's classification), a high dopamine level, and/or a high homovanillic acid/vanillylmandelic acid ratio.
Conclusions:
Mass screening of children age 14 months for neuroblastoma detects cases missed or unscreened at age 6 months, though the detection rate appears to be in excess of what would be expected from natural incidence.
