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Previous Volume 346:1041-1046 April 4, 2002 Number 14 Next

	Full Text PDF PDA Full Text PowerPoint Slide Set Supplementary Material Editorial by Cunningham, G. Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

ABSTRACT

Background Neuroblastoma, the most common extracranial solid tumor that occurs in early childhood, can be identified in the preclinical stages by the detection of catecholamines in the urine. However, it is unknown whether routine screening for neuroblastoma reduces mortality due to this disease.

Methods Through their parents, we offered screening for neuroblastoma at three weeks and six months of age to all 476,654 children born in the province of Quebec, Canada, during a five-year period (May 1, 1989, through April 30, 1994). The participation rate was 92 percent. The rate of death due to neuroblastoma was determined and compared with the rates in several unscreened control populations born during the same period.

Results Among children younger than eight years of age in the Quebec cohort, there were 22 deaths due to neuroblastoma; the cumulative (±SE) mortality rate due to neuroblastoma was 4.78±1.14 per 100,000 children over a period of nine years. The standardized incidence ratios for death due to neuroblastoma for the Quebec cohort were 1.11 (95 percent confidence interval, 0.64 to 1.92) as compared with a control group in Ontario, Canada; 0.90 (95 percent confidence interval, 0.48 to 1.70) as compared with a control group in Minnesota; 1.40 (95 percent confidence interval, 0.81 to 2.41) as compared with a control group in Florida; and 0.96 (95 percent confidence interval, 0.56 to 1.66) as compared with a control group in the Greater Delaware Valley. The standardized mortality ratio for the Quebec cohort as compared with the rest of Canada was 1.39 (95 percent confidence interval, 0.85 to 2.30); the odds ratio for the comparison with a cohort born in Quebec before the screening program began was 0.98 (95 percent confidence interval, 0.54 to 1.77).

Conclusions Screening infants for neuroblastoma does not appear to reduce mortality due to this disease.

Source Information

From the AFLAC Cancer Center, Emory University and Children's Healthcare of Atlanta, Atlanta (W.G.W.); Statistics Canada, Ottawa, Ont. (R.-N.G.); University of Florida, Gainesville (J.J.S.); University of Minnesota, Minneapolis (L.L.R.); Hôpital Sainte-Justine, Montreal (M.B.); Hospital for Sick Children, Toronto (S.W.); Children's Hospital of Philadelphia, Philadelphia (G.B.); Canadian Medical Association, Ottawa, Ont. (I.L.); Centre Universitaire de Santé de l'Estrie, Sherbrooke, Que., Canada (J.B., B.L.); Montreal Children's Hospital, Montreal (G.D.), and Children's National Medical Center, Washington, D.C. (M.T.).

Address reprint requests to Dr. Woods at the AFLAC Cancer Center, Emory University and Children's Healthcare of Atlanta at Egleston, 1405 Clifton Rd., NE, Rm. 319, Atlanta, GA 30322, or at william.woods{at}choa.org.

Full Text of this Article

Related Letters:

Neuroblastoma Screening in Early Life
Suita S., Kerbl R., Urban C. E., Ambros P. F., Collins M. H., Green N. S., Woods W. G., Bernstein M., Robison L. L., Schilling F. H., Spix C., Berthold F.
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N Engl J Med 2002; 347:852-854, Sep 12, 2002. Correspondence

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