A 5-year (1990-1994) neuroblastoma screening feasibility study in France. Methodology and preliminary observations.
BACKGROUND
Following the pioneering Japanese experience, several European and North American groups implemented pilot studies on screening infants for neuroblastoma, considering the possibility of demonstrating a decrease in mortality rate. In France, a 5-year (1990-1994) feasibility study on neuroblastoma screening at the age of 4 months was initiated in the Rhône district (1.5 M inhabitants, 26,000 births per year).


METHODS
Vanillylmandelic (VMA) and homovanillic (HVA) acids were measured by HPLC, and creatinine (Cr) by the Jaffé's kinetic method on Technicon RA-XT. VMA and HVA were expressed as microgram/mg of Cr. The method was assessed with both a daily intra-laboratory control and a sample of urine obtained from a national quality control organism.


CONCLUSIONS
The overall participation rate for the 5-year period was 82.2%. Out of 105,293 infants tested from 128,126 births, 12 NB cases were discovered with screening (screened cases) and 1 case was discovered with a late performed test (at 13 months of age). Six neuroblastomas were found clinically before the age of 4 m. Two cases were missed because the parents did not perform the test. Three children with normal tests at screening were false-negative cases: two of them were found secreting at diagnosis, while one remained non-secretory at diagnosis and later on. Otherwise, thirty-five false-positive tests were found. Biochemical observations are discussed. It is too early to reach clinical conclusions from this screening program on neuroblastomas as it is presently being followed up.
Mathieu
P
P
Service de Biologie Générale et de Neurobiologie, Centre hospitalier du Vinatier, Bron-Lyon, France.
Frappaz
D
D
Chauvin
F
F
Combaret
V
V
Vercherat
M
M
Brunat-Mentigny
M
M
David
L
L
Esteve
J
J
Favrot
M
M
Fouillat
V
V
Greffe
J
J
Lasset
C
C
Renaud
P
P
Philip
T
T
D002851:Chromatography, High Pressure Liquid; D003404:Creatinine / Q000032:analysis / Q000652:urine; D005188:False Negative Reactions; D005189:False Positive Reactions; D005602:France; D006719:Homovanillic Acid / Q000032:analysis / Q000652:urine; D006801:Humans; D007223:Infant; D008403:Mass Screening / Q000379:methods* / Q000706:statistics & numerical data; D009447:Neuroblastoma / Q000453:epidemiology / Q000517:prevention & control*; D011237:Predictive Value of Tests; D012016:Reference Values; D014642:Vanilmandelic Acid / Q000032:analysis / Q000652:urine
D014642:Vanilmandelic Acid; D003404:Creatinine; D006719:Homovanillic Acid