A 5-YEAR (1990-1994) NEUROBLASTOMA SCREENING FEASIBILITY STUDY IN FRANCE - METHODOLOGY AND PRELIMINARY-OBSERVATIONS

Introduction: Following the pioneering Japanese experience, several Eu ropean and North American groups implemented pilot studies on screenin g infants for neuroblastoma, considering the possibility of demonstrat ing a decrease in mortality rate. In France, a 5-year (1990-1994) feas ibility study on neuroblastoma screening at the age of 4 months was in itiated in the Rhone district (1.5 M inhabitants, 26 000 births per ye ar). Methods: Vanillylmandelic (VMA) and homovanillic (HVA) acids were measured by HPLC, and creatinine (Cr) by the Jaffe's kinetic method o n Technicon RA-XT(TM). VMA and HVA were expressed as mu g/mg of Cr. Th e method was assessed with both a daily intra-laboratory control and a sample of urine obtained from a national quality control organism. Re sults and discussion: The overall participation rate for the 5-year pe riod 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 wa s discovered with a late performed test (at 13 months of age). Six neu roblastomas were found clinically before the age of 4 m. Two cases wer e 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 w ere found. Biochemical observations are discussed. It is too early to reach clinical conclusions from this screening program on neuroblastom a as it is presently being followed up.