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Neuroblastoma Screening at 1 Year of Age: The Final Results of a Controlled Trial.
- Source :
-
JNCI cancer spectrum [JNCI Cancer Spectr] 2021 May 05; Vol. 5 (4). Date of Electronic Publication: 2021 May 05 (Print Publication: 2021). - Publication Year :
- 2021
-
Abstract
- Background: Neuroblastoma screening aims to reduce neuroblastoma-related mortality. A controlled trial showed no reduction in stage 4 disease incidence and preliminary mortality data. This article presents epidemiologic and clinical data 20 years after cessation of the screening program.<br />Methods: The patients with detected disease in the screening area were compared with the clinically diagnosed patients in the control area and in the prestudy and poststudy cohorts. All statistical tests were 2-sided.<br />Results: The cumulative incidence for children aged 1 to 6 years in the birth study cohorts (1994-1999) in the screening arm was 13.4 cases per 100 000 births (95% confidence interval [CI] = 12.2 to 14.6) based on 61.2% of screening participants and 38.8% of nonparticipants. Screening participants had a cumulative incidence of 15.7 (95% CI = 14.0 to 17.4) per 100 000 births. The cumulative incidence in the contemporary control cohort was 9.3 (95% CI = 8.2 to 10.3) per 100 000 births, 7.6 (95% CI = 6.8 to 8.4) in the prestudy cohort, and 8.1 (95% CI = 7.4 to 8.9) in the poststudy cohort from 2000 to 2004 ( P < .001 each). The increased incidence in the screening cohort was restricted to stages 1 through 3, while stage 4 incidence was not reduced. The cumulative mortality for deaths within 10 years from diagnosis and per 100 000 births remained unchanged. Patients with stage 4 disease detected by screening had better biological characteristics and an improved outcome compared with those stage 4 cases not detected by screening.<br />Conclusions: Neuroblastoma screening at 1 year of age reduced neither stage 4 incidence nor neuroblastoma mortality and was affected by overdiagnosis, leading to unnecessary treatment. A few screening-detected stage 4 cases represent a biologically interesting subgroup but do not change the recommendation to close the "catecholamine-based neuroblastoma screening book."<br /> (© The Author(s) 2021. Published by Oxford University Press.)
- Subjects :
- Biomarkers, Tumor urine
Birth Rate
Catecholamines urine
Child
Child, Preschool
Cohort Studies
Confidence Intervals
Germany epidemiology
Humans
Incidence
Infant
Neuroblastoma mortality
Neuroblastoma pathology
Overdiagnosis
Overtreatment
Progression-Free Survival
Risk Factors
Time Factors
Early Detection of Cancer methods
Mass Screening statistics & numerical data
Neuroblastoma diagnosis
Neuroblastoma epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 2515-5091
- Volume :
- 5
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- JNCI cancer spectrum
- Publication Type :
- Academic Journal
- Accession number :
- 34240006
- Full Text :
- https://doi.org/10.1093/jncics/pkab041