Y. Hayashi et al., PROBLEMS OF NEUROBLASTOMA SCREENING FOR 6-MONTH-OLDS AND RESULTS OF 2ND SCREENING FOR 18-MONTH-OLDS, Journal of pediatric surgery, 30(3), 1995, pp. 467-470
Nationwide neuroblastoma mass screening for 8-month-old infants (first
screening) was introduced in Japan in 1985. About 110 neuroblastoma c
ases are detected annually by the first screening and treated, with a
survival rate of 97%. Sensitivity of the first screening (positive cas
es/positive cases + false negative cases) is about 75%, and the progno
sis of false-negative cases is unfavorable. A second screening at 18 m
onths of age was started to rescue false negative cases in Miyagi Pref
ecture in May 1992. Of 62 neuroblastoma cases treated in our hospital
since 1985, 40 cases had received the first screening. Twenty cases we
re positive at first screening, 18 cases were false negative, and 2 ca
ses were false negative and picked up by the second screening. Age dis
tribution of false-negative cases ranged from 12 to 83 months and incl
uded 12 cases younger than 36 months old. Only 5 of 18 false-negative
cases are alive without the disease, From May 1992 to November 1993, 1
4,282 infants had received the second screening (compliance rate: abou
t 75%), and 2 neuroblastoma cases were detected. The first case was st
age III with paraortic lymph node metastases, Shimada UH, aneuploidy a
nd negative N-myc amplification. The second case was stage II with Shi
mada FH, aneuploidy, and negative N-myc amplification. Both cases are
alive now without the disease after undergoing radical operation and c
hemotherapy. The first screening is effective for early detection of n
euroblastoma cases, but the sensitivity is insufficient; the authors r
ecommend a second screening to rescue false-negative cases.