Neuroblastoma screening in infants postponed after the sixth month of age: A trial to reduce “overdiagnosis” and to detect cases with “unfavorable” biologic features

Kerbl, Reinhold; Urban, Christian; Ladenstein, Ruth; Ambros, Inge M.; Spuller, Ekkehard; Mutz, I; Amann, Gabriele; Kovar, Heinrich; Gadner, Helmut; Ambros, Peter F.

doi:10.1002/(sici)1096-911x(199707)29:1<1::aid-mpo1>3.0.co;2-j

Cited by 37 publications

(29 citation statements)

References 51 publications

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“…[3][4][5][6] According to the report from Europe (SENSE Group: United Kingdom, Germany, France, and Austria), 434,538 infants were screened between September 1992 and June 1997, out of 922,171 live births using assessment of urinary VMA and HVA through HPLC, gas chromatography-mass spectroscopy, and a total of 53 patients were detected through screening. 3 Overdiagnosis was suggested, and whether advanced cases older than 1 year of age have decreased in incidence has not yet been reported.…”

Section: Discussionmentioning

confidence: 99%

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

Yamamoto

Ohta²,

Ito³

et al. 2002

Journal of Clinical Oncology

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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.

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Section: Discussionmentioning

confidence: 99%

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

Yamamoto

Ohta²,

Ito³

et al. 2002

Journal of Clinical Oncology

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“…Attempts to institute screening programs to diagnose neuroblastoma at six months of age in order to prevent later cases have shown that, in fact, neuroblastomas that are diagnosed among preschoolers often do not represent progress from infant neuroblastoma, but are in fact separate clinical entities [2,3,[10][11][12]. Screening programs identifying infant neuroblastoma have failed to reduce mortality from the disease, or even lessen the rates of neuroblastoma in older age groups, although delaying screening to age 12 months improved the results [13][14][15]. The conclusion was that more children may be needlessly treated than would benefit from screening [12,16].…”

Section: Introductionmentioning

confidence: 99%

Perinatal risk factors for neuroblastoma

McLaughlin

Baptiste

Schymura

et al. 2008

Cancer Causes Control

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Neuroblastoma is the most common cancer among infants, suggesting an etiologic role for prenatal factors. In this case-cohort study, neuroblastoma cases (n = 529) diagnosed between 1985 and 2001 were identified from the New York State Cancer Registry and were matched to the electronic birth records for 1983-2001 from New York State and New York City. Controls (n = 12,010) were selected from the same birth cohorts. Analysis was stratified by age at diagnosis, with one to six months (younger infants), seven to 18 months (older infants), and older than 18 months (older children) analyzed separately. Perinatal exposure data was obtained from the birth certificates. No risk factors were identified to be consistently associated with risk across all three age groups. Generally, more risk factors were identified as associated with neuroblastoma among younger infants relative to older ages, including high birth weight, heavier maternal gestational weight gain, maternal hypertension, older maternal age, ultrasound, and respiratory distress. Among older infants, low birth weight was associated with increased risk while heavier maternal gestational weight gain was protective. In the oldest age group, first born status, primary cesarean delivery, prolonged labor and premature rupture of the membranes were associated with increased risk.

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“…Außerdem haben Screening-Programme zu einem vertieften Verständnis und Einblick in die Natur des Neuroblastoms beigetragen. Der Beginn der Beschreibung der Tumorheterogenitäten in Hinblick auf das biologische Profil bei Kindern jeder Altersklasse durch Ambros und Mitarbeiter (Ambros et al 2001b) fußt im österreichischen, regional durchgeführten Screening-Programm (Kerbl et al 1997(Kerbl et al , 2003.…”

Section: Prävention Früherkennung Und Screeningunclassified

“…Es besteht die Möglichkeit, diese Stoffe mittels hochsensitiver Methoden (HPLC) u. a. auch auf mit Urin benetztem Filterpapier nachzuweisen. Dieses Vorgehen wurde beim Neuroblastom-Screening im Säuglingsalter eingesetzt (Kerbl et al 1997 (Berthold et al 1992;Hann et al 1985). Auch die neuronspezifische Enolase kann als Tumormarker im Verlauf eingesetzt werden.…”

Section: Labordiagnostikunclassified