title: Mass screening for neuroblastoma at 6 months of age: difficult to justify.
abstract: OBJECTIVE
  A statistical analysis of the mass screening for neuroblastoma in Japan based on a population study rarely has been reported. This study aims to evaluate retrospectively the effectiveness of mass screening at 6 months of age using the available population data.
  
  
  METHODS
  The data on the neuroblastoma cases registered by the Committee for Pediatric Solid Malignant Tumors in the Kyushu area were analyzed based on both screened and unscreened populations in the Kyushu area.
  
  
  RESULTS
  From 1988 to 1992, the cumulative incidence of neuroblastoma in children less than 5 years of age was 82 in 484,599 for screened children, and 11 in 92,966 for unscreened children, respectively. Fourteen of the 82 screened patients had negative findings at 6 months of age (MS-negative cases). No significant difference was observed in the cumulative mortality rates from neuroblastoma in children younger than 5 years of age between the screened children and the unscreened children. Six of seven patients who died among the screened children were MS-negative cases with stage III or IV disease. In addition, no significant difference was found in the cumulative mortality rates from the neuroblastoma cases in patients less than 5 years of age between the children screened from 1988 to 1992 (7 of 484,599) and all children from 1980 to 1984 (14 of 668,084).
  
  
  CONCLUSIONS
  These findings suggests that the majority of the patients detected by mass screening had a favorable prognosis, and, mass screening in Japan for children less than 6 months of age was not observed to reduce the incidence and mortality from neuroblastoma. Therefore, mass screening at 6 months of age was not found to improve substantially the prognosis of patients with unfavorable neuroblastoma identified over 1 year of age, which is the primary purpose of such mass screening for neuroblastoma.
authors.affiliation: Department of Pediatric Surgery, Kyushu University, Fukuoka, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Suita
authors.forename: T
authors.initials: T
authors.lastname: Tajiri
authors.forename: K
authors.initials: K
authors.lastname: Akazawa
authors.forename: Y
authors.initials: Y
authors.lastname: Sera
authors.forename: H
authors.initials: H
authors.lastname: Takamatsu
authors.forename: H
authors.initials: H
authors.lastname: Mizote
authors.forename: H
authors.initials: H
authors.lastname: Ohgami
authors.forename: N
authors.initials: N
authors.lastname: Kurosaki
authors.forename: T
authors.initials: T
authors.lastname: Hara
authors.forename: J
authors.initials: J
authors.lastname: Okamura
authors.forename: S
authors.initials: S
authors.lastname: Miyazaki
authors.forename: T
authors.initials: T
authors.lastname: Sugimoto
authors.forename: K
authors.initials: K
authors.lastname: Kawakami
authors.forename: M
authors.initials: M
authors.lastname: Tsuneyoshi
authors.forename: H
authors.initials: H
authors.lastname: Tasaka
authors.forename: H
authors.initials: H
authors.lastname: Yano
authors.forename: H
authors.initials: H
authors.lastname: Akiyama
authors.forename: K
authors.initials: K
authors.lastname: Ikeda
mesh_terms: D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007564:Japan / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000458:organization & administration*; D009447:Neuroblastoma / Q000175:diagnosis / Q000453:epidemiology*; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D015996:Survival Rate