Screening for neuroblastoma: a 9–year birth cohort–based study in Niigata, Japan

Between April 1985 and March 1994 (9 years), 229 346 babies were born in Niigata prefecture, and 201 888 (88.0%) underwent mass screening (MS) for neuroblastoma at 6 months of age. To date, 29 infants have been screen–detected as having neuroblastoma (1 :7908). All screen–detected patients survived after removal of the primary tumor. In the same birth cohort, 17 additional children were clinically diagnosed as having neuroblastoma. The cumulative incidence rate of neuroblastoma at 5 years of age was 10.5 per 100 000 live births in the 5–year birth cohort before MS was introduced, and 18.6 per 100000 in the first 5–year birth cohort after MS was introduced. These values were not statistically different. The birth cohort incidence rate increased significantly to 22.2 per 100000 (p < 5% compared with before MS) after the method of MS was changed to high–power liquid chromatography (HPLC), even though this latest birth cohort has not been followed for 5 years. The population–based mortality rate from neuroblastoma was 5.9 per 100 000 in the 5–year birth cohort before MS, and 4.5 per 100000 after MS in the first 5–year birth cohort, using the vanillymandelic acid (VMA) spot test. These values were not statistically significant. In contrast, no death was observed in the next 4–year birth cohort after MS using HPLC; however, this birth chohort has not yet been followed for 5 years.Mass screening, neuroblastoma