Care of Neuroblastoma

Mass Screening for Neuroblastoma

Mass screening for cancer is widely performed in adults. Its objective is to detect cancer early, before it has progressed to uncurable stages.

In most cases, neuroblastoma arises from adrenal gland tissues or nerve tissues in the abdomen and pelvis, as well as other nerve tissues. Neuroblastoma has usually spread to other parts of the body by the time it is diagnosed and is found as an advanced tumor. It is hard to cure an advanced tumor, and the survival rate is low. Meanwhile, neuroblastoma cells are known to excrete some chemical substances (VMA, HMA, etc.) in the urine, and analysis of the levels of these substances is used for the diagnosis or evaluation of the treatment efficacy. Therefore, screening of six-month olds for neuroblastoma via analysis of the levels of the substances was performed with the aim of early detection before tumor progression.

In Japan, mass screening was started as a nationwide program in 1984. More than 22 million infants had undergone the screening tests by 1998, and approximately 2,700 cases of neuroblastoma were found. Some other countries also introduced mass screening, and studies were conducted to determine the efficacy of the screening. There was a report that the screening caused an increase in diagnoses, but that it did not lead to a reduction in cases of advanced tumors or rate of death due to neuroblastoma. Another report, however, showed the benefit of screening. In addition, some pointed out that mass screening may cause overdiagnosis of neuroblastoma and an increase in complications associated with treatment. Mass screening was halted in 2003 in Japan and is not performed any longer in other countries. In some regions in Japan, the timing of the screening has been changed to 18 months after birth, and screening is continued on a research basis, while its efficacy is still inconclusive.

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