Mass Screening for Neuroblastoma Necessity for Rediscussion

Abstract

In this article, the history of mass screening for neuroblastoma (NBMS) targeting 6-month-old infants is briefly described, and the change in the mortality after stopping NBMS is reported. Several cohort studies performed to evaluate NBMS are summarized, as well. NBMS was previously performed on a nationwide scale in Japan targeting 6-month-old infants, and after 1992 all the specimens were measured by high performance liquid chromatography (HPLC). But NBMS stopped in most communities by the spring 2004. For the purpose of estimating the influence of stopping NBMS, we investigated the mortality rates of the children who died of neoplasms of the adrenal glands at the ages of 1 to 4 years by birth cohorts from the introduction of HPLC to the period after stopping NBMS. The mortality rate in the birth cohort from 1992 to 2003, most of whose members participated in NBMS with HPLC, was significantly lower than the mortality rate in the cohort from 1989 to 1991 (P<0.01). The mortality rate in the cohort from 2004 to 2006, most of whose members were not screened, was the highest among the cohorts after 1992, and the significant difference from the mortality rate in the cohort from 1989 to 1991 disappeared. Considering the increasing mortality of the neoplasms of the adrenal glands in Japan and the recent results of the cohort studies revealing the effectiveness of NBMS, it is necessary to discuss its restart on a nationwide scale.