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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
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Un estudio basado en la población de la utilidad de la detección de neuroblastoma
W G Woods1, M Tuchman, L L Robison
1University of Minnesota, Minneapolis, USA.
Lancet (London, England)
|December 21, 1996
Resumen
La detección masiva de neuroblastoma en bebés aumenta las tasas de detección, pero no reduce la incidencia de la enfermedad en estadio avanzado en niños mayores. Esto sugiere que es poco probable que el cribado infantil reduzca la mortalidad general por neuroblastoma.
Área de la Ciencia:
- Oncología Pediátrica Oncología Pediátrica.
- Programas de detección de salud pública Programas de detección de salud pública.
- Epidemiología del cáncer Epidemiología del cáncer
Sus antecedentes:
- La detección del neuroblastoma antes de que aparezcan los síntomas puede mejorar los resultados.
- El Proyecto de Cribado de Neuroblastoma de Quebec tenía como objetivo evaluar si el cribado masivo reduce la mortalidad infantil.
- Este estudio informa sobre el efecto del cribado en la incidencia de neuroblastoma de mal pronóstico en niños mayores de un año.
Objetivo del estudio:
- Para determinar si el cribado masivo de neuroblastoma en bebés reduce la mortalidad.
- Evaluar el impacto del cribado en la incidencia de neuroblastoma en estadio avanzado en niños mayores de un año.
Principales métodos:
- Los bebés en Quebec (n=476,603) se sometieron a ensayos de catecolaminas urinarias a las 3 semanas y 6 meses.
- Las evaluaciones positivas condujeron a la evaluación y al tratamiento.
- Se calcularon los ratios de incidencia estandarizados (SIR) comparando Quebec con Minnesota y Ontario.
Principales resultados:
- El cumplimiento del cribado fue alto (91% a las 3 semanas, 74% a los 6 meses).
- Se diagnosticaron 118 casos de neuroblastoma; 43 preclínicamente, 20 clínicamente antes de 3 semanas y 55 clínicamente después de 3 semanas.
- Quebec mostró una incidencia significativamente mayor (SIR 2.17), particularmente en bebés menores de un año (SIR 2.85), sin reducción en la enfermedad en etapa avanzada en niños mayores.
Conclusiones:
- La detección del neuroblastoma infantil aumenta la incidencia diagnosticada sin reducir la enfermedad avanzada desfavorable en niños mayores.
- Es poco probable que los protocolos actuales de cribado infantil disminuyan la mortalidad relacionada con el neuroblastoma.
- Es posible que se necesite más investigación para identificar estrategias de detección más efectivas.
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