Treatment complications in children diagnosed with neuroblastoma during a screening program.
OBJECTIVE
The Québec Neuroblastoma Screening Program was put in place to investigate the possibility of decreasing mortality from high-risk neuroblastoma through early screening. We assess treatment complications in the patients diagnosed during this screening program.


METHODS
A total of 476,603 patients born during the screening period were eligible. Parents of 425,838 children (89%) agreed to participate in the 3-week screening, and 73% agreed to participate in the 6-month screening. Forty-five patients had neuroblastoma. We reviewed the medical and research charts for all patients diagnosed by screening. Follow-up was available from 8 to 13 years after screening.


RESULTS
Forty-five patients were diagnosed by screening. All patients were treated according to the Pediatric Oncology Group recommendations of the time. All patients had surgery, and 29 patients received chemotherapy. No patient died from neuroblastoma. Eleven patients suffered complications from treatment. Two patients had life-threatening complications.


CONCLUSIONS
In view of the lack of impact of screening programs on neuroblastoma mortality, evidence that many of the tumors detected through screening can be observed without treatment and the serious complications that may arise from therapy, we do not support neuroblastoma screening programs for children.
Barrette
Stéphane
S
Hôpital Ste-Justine, Montréal, Québec, Canada. stephane.barrette@umontreal.ca
Bernstein
Mark L
ML
Leclerc
Jean-Marie
JM
Champagne
Martin A
MA
Samson
Yvan
Y
Brossard
Josée
J
Woods
William G
WG
D006719:Homovanillic Acid / Q000652:urine; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008403:Mass Screening; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D014642:Vanilmandelic Acid / Q000652:urine
D014642:Vanilmandelic Acid; D006719:Homovanillic Acid