Marginal Decrease in Mortality and Marked Increase in Incidence as a Result of Neuroblastoma Screening at 6 Months of Age: Cohort Study in Seven Prefectures in Japan

Abstract

Six-month screening resulted in a marked increase in incidence for infants with no significant decrease in incidence for children older than 1 year of age. A decrease in mortality was observed, but it was not significant. The usefulness of screening is questionable, because the decrease of mortality should be balanced against the adverse effect of overdiagnosis and the psychological burden on parents and children.

Risks and benefits of ending of mass screening for neuroblastoma at 6 months of age in Japan

“…Likewise, the number of patients younger than 1 year as well as the number of cases with early stage NB has also increased. However, the number of advanced-stage NB patients older than 1 year has not substantially changed in several reports [5,6]. These findings imply that a number of tumors in this age group (6 months of age) have the capacity to either spontaneously regress or mature, and thus they may not be detected clinically.…”

Heterogeneous subgroups in human neuroblastoma for clinically relevant risk stratification

“…These findings contribute to our understanding of the natural history of neuroblastoma because the distribution of favorable tumors has not been well investigated thoroughly. On the other hand, some tumors that might be detected in individual more than 1 year-of age had been screened out, so that the mortality rates of neuroblastoma were reported to be reduced [4,12]. The simulation model of neuroblastoma development is an intriguing strategy to evaluate the heterogeneous subgroups of human neuroblastoma and to distinguish unfavorable tumors from favorable tumors.…”

“…Based on this concept, neuroblastoma MS began in Japan in 1980, and a nationwide MS program was implemented between 1985 and 2003. Population-based evaluation of this program has been performed, and some reports have described a beneficial effect for decreasing disease-related mortality [2], while others have not [3,4].…”

Paternal occupational exposure to pesticides and risk of neuroblastoma among children: a meta-analysis

“…Despite having a high rate of spontaneous regression, late stage disease (approximately 50% of cases) [3] is associated with three-year survival rates in the 30-40% range even after intense multimodal therapy [4,5]. Although infant screening programs in several countries resulted in increased incidence of NB, possibly due to improved identification of more benign cases, very little or no decrease in mortality was observed [6][7][8][9]. Identification and better understanding of risk factors of NB may facilitate disease prevention.…”