NEUROBLASTOMA SCREENING IN THE UNITED-STATES - RESULTS OF THE TEXAS OUTREACH PROGRAM FOR NEUROBLASTOMA SCREENING

BACKGROUND. Mass screening of infants for neuroblastoma began in Japan after studies suggested that survival rates could be improved by earl y detection. This study was initiated in 1991 to test the methodology and feasibility of screening for neuroblastoma within the U. S. health care system. METHODS, Infants ages 5-10 months (mean age, 9 months, 2 5 days) who were born in Texas were screened for neuroblastoma. An enz yme-linked immunoadsorbent assay (ELISA) for homovanillic acid (KVA) a nd vanillylmandelic acid (VMA) used to quantify the HVA and VMA was pe rformed on urine extracted from specimens dried on filter paper. Infan ts were recruited to participate in the study by several methods, and the effectiveness of each method was determined by calculating complia nce rates. RESULTS, Between February 1991 and June 1994 a total of 14, 046 infants were recruited to participate in neuroblastoma screening. Neuroblastoma was detected in 2 children for an incidence rate of 1 in 7023. A total of 291,158 screening kits were distributed to the paren ts of these infants, resulting in an overall compliance rate of only 4 .8%. Compliance rates varied by method of distribution of the test kit s: Houston Women, Infants, and Children (WIG) clinic (53%), volunteers (31%), Rio Grande Valley WIC clinics (14.5%), the patient's private p hysician (9.9%), and by mail (4.7%). CONCLUSIONS, Early detection of n euroblastoma in infants ages 5-10 months was achieved using ELISA, Com pliance rates were poor, but clinics with a preventive health focus, s uch as the WIC clinics, achieved higher compliance rates than did priv ate physicians. (C) 1998 American Cancer Society.