BACKGROUND: In Sapporo City a mass screening program for neuroblastoma targeting children age 6 months (6-MS) was initially introduced in 1981. Since April 1991, an additional program has been implemented, aimed at children age 14 months (14-MS). METHODS: High performance liquid chromatography was employed in the 14-MS. Identification of cases was dependent on the Registry of Childhood Malignancies in the Hokkaido Prefecture. RESULTS: Of the 85,783 live births in Sapporo City during the period 1990-1994, a total of 56,444 participated in the 14-MS (compliance rate, 65.8%). By the end of 1996, of 48,448 children who had previously taken part in the 6-MS, 6 cases were identified in the 14-MS, and 1 additional case screened negative but was later diagnosed clinically. Two more cases were detected in the 14-MS among the 7996 children who had not participated in the 6-MS. Though the incidence of cases identified by the 14-MS was much higher than expected, several true-positive cases had unfavorable histology (as defined by Shimada's classification), a high dopamine level, and/or a high homovanillic acid/vanillylmandelic acid ratio. CONCLUSIONS: Mass screening of children age 14 months for neuroblastoma detects cases missed or unscreened at age 6 months, though the detection rate appears to be in excess of what would be expected from natural incidence.
BACKGROUND: In Sapporo City a mass screening program for neuroblastoma targeting children age 6 months (6-MS) was initially introduced in 1981. Since April 1991, an additional program has been implemented, aimed at children age 14 months (14-MS). METHODS: High performance liquid chromatography was employed in the 14-MS. Identification of cases was dependent on the Registry of Childhood Malignancies in the Hokkaido Prefecture. RESULTS: Of the 85,783 live births in Sapporo City during the period 1990-1994, a total of 56,444 participated in the 14-MS (compliance rate, 65.8%). By the end of 1996, of 48,448 children who had previously taken part in the 6-MS, 6 cases were identified in the 14-MS, and 1 additional case screened negative but was later diagnosed clinically. Two more cases were detected in the 14-MS among the 7996 children who had not participated in the 6-MS. Though the incidence of cases identified by the 14-MS was much higher than expected, several true-positive cases had unfavorable histology (as defined by Shimada's classification), a high dopamine level, and/or a high homovanillic acid/vanillylmandelic acid ratio. CONCLUSIONS: Mass screening of children age 14 months for neuroblastoma detects cases missed or unscreened at age 6 months, though the detection rate appears to be in excess of what would be expected from natural incidence.