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BMJ. 1992 November 21; 305(6864): 1260–1263.
PMCID: PMC1883723

Screening for neuroblastoma in the north of England.

Abstract

OBJECTIVE--To determine the feasibility of establishing a system of screening for neuroblastoma. DESIGN--Prospective study of mass screening in four clearly defined geographical areas. SETTING--Four health districts of the Northern region of England. SUBJECTS--20,829 babies aged 6 months, 92% of target population. INTERVENTIONS--Collection of urine on filter paper for analysis of content of homovanillic and vanillylmandelic acid in relation to urinary creatinine concentrations. MAIN OUTCOME MEASURES--Derivation of reference range. Identification of babies with homovanillic or vanillylmandelic acid > 3 SD above the mean (positive cases). Investigation of positive cases for evidence of neuroblastoma. RESULTS--The upper limit of normal (3 SD above the mean) for vanillylmandelic acid was 15 mumol/mmol creatinine and for homovanillic acid 24 mumol/mmol creatinine. Of the 20,829 babies screened, 2537 (12.2%) required a second sample to be taken because the first sample was inadequate. Of these, 527 (2.5%) provided a liquid urine specimen and 10 (0.04%) had positive results for neuroblastoma. Two of them had neuroblastoma (true positives) and eight did not (false positives). A further three children from the cohort were subsequently found to have neuroblastoma; they had raised homovanillic acid or vanillylmandelic acid values, or both, but screened negative at 6 months. CONCLUSIONS--Screening for neuroblastoma is possible in the health care system of the United Kingdom. Evaluation of the efficacy of screening in reducing the mortality from neuroblastoma requires a controlled trial.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Craft AW, Amineddine HA, Scott JE, Wagget J. The Northern region Children's malignant disease registry 1968-82: incidence and survival. Br J Cancer. 1987 Dec;56(6):853–858. [PMC free article] [PubMed]
  • Shafford EA, Rogers DW, Pritchard J. Advanced neuroblastoma: improved response rate using a multiagent regimen (OPEC) including sequential cisplatin and VM-26. J Clin Oncol. 1984 Jul;2(7):742–747. [PubMed]
  • Evans AE, D'Angio GJ, Propert K, Anderson J, Hann HW. Prognostic factor in neuroblastoma. Cancer. 1987 Jun 1;59(11):1853–1859. [PubMed]
  • Tuchman M, Ramnaraine ML, Woods WG, Krivit W. Three years of experience with random urinary homovanillic and vanillylmandelic acid levels in the diagnosis of neuroblastoma. Pediatrics. 1987 Feb;79(2):203–205. [PubMed]
  • Sawada T, Hirayama M, Nakata T, Takeda T, Takasugi N, Mori T, Maeda K, Koide R, Hanawa Y, Tsunoda A, et al. Mass screening for neuroblastoma in infants in Japan. Interim report of a mass screening study group. Lancet. 1984 Aug 4;2(8397):271–273. [PubMed]
  • Nishi M, Miyake H, Takeda T, Shimada M, Takasugi N, Sato Y, Hanai J. Effects of the mass screening of neuroblastoma in Sapporo City. Cancer. 1987 Aug 1;60(3):433–436. [PubMed]
  • Dale G, McGill AC, Seviour JA, Craft AW. Urinary excretion of HMMA and HVA in infants. Ann Clin Biochem. 1988 May;25(Pt 3):233–236. [PubMed]
  • Seviour JA, McGill AC, Dale G, Craft AW. Method of measurement of urinary homovanillic acid and vanillylmandelic acid by gas chromatography-mass spectrometry suitable for neuroblastoma screening. J Chromatogr. 1988 Nov 18;432:273–277. [PubMed]
  • Tuchman M, Lemieux B, Auray-Blais C, Robison LL, Giguere R, McCann MT, Woods WG. Screening for neuroblastoma at 3 weeks of age: methods and preliminary results from the Quebec Neuroblastoma Screening Project. Pediatrics. 1990 Nov;86(5):765–773. [PubMed]
  • Nishi M, Miyake H, Takeda T, Shimada M, Takasugi N, Sato Y, Hanai J. Incidence of neuroblastoma in Sapporo city. J Pediatr Surg. 1990 May;25(5):545–546. [PubMed]
  • Look AT, Hayes FA, Shuster JJ, Douglass EC, Castleberry RP, Bowman LC, Smith EI, Brodeur GM. Clinical relevance of tumor cell ploidy and N-myc gene amplification in childhood neuroblastoma: a Pediatric Oncology Group study. J Clin Oncol. 1991 Apr;9(4):581–591. [PubMed]
  • Brodeur GM, Hayes FA, Green AA, Casper JT, Wasson J, Wallach S, Seeger RC. Consistent N-myc copy number in simultaneous or consecutive neuroblastoma samples from sixty individual patients. Cancer Res. 1987 Aug 15;47(16):4248–4253. [PubMed]
  • Hanawa Y, Sawada T, Tsunoda A. Decrease in childhood neuroblastoma death in Japan. Med Pediatr Oncol. 1990;18(6):472–475. [PubMed]
  • Cole M, Parker L, Craft A. "Decrease in childhood neuroblastoma death in Japan," Hanawa et al. (1990) Med Pediatr Oncol. 1992;20(1):84–85. [PubMed]
  • Nishi M, Miyake H, Takeda T, Takasugi N, Sato Y, Hanai J, Kawai T. Cases of neuroblastoma missed by the mass screening programs. Pediatr Res. 1989 Dec;26(6):603–607. [PubMed]

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