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Neuroblastoma screening in the united states
Author(s) -
Ater Joann L.,
Gardner Kristina L.,
Foxhall Lewis E.,
Therrell Brad L,
Bleyer W. Archie
Publication year - 1998
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(19980415)82:8<1593::aid-cncr23>3.0.co;2-z
Subject(s) - medicine , vanillylmandelic acid , neuroblastoma , incidence (geometry) , pediatrics , urine , homovanillic acid , physics , receptor , biology , serotonin , optics , genetics , cell culture
BACKGROUND Mass screening of infants for neuroblastoma began in Japan after studies suggested that survival rates could be improved by early 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, 25 days) who were born in Texas were screened for neuroblastoma. An enzyme‐linked immunoadsorbent assay (ELISA) for homovanillic acid (HVA) and vanillylmandelic acid (VMA) used to quantify the HVA and VMA was performed on urine extracted from specimens dried on filter paper. Infants were recruited to participate in the study by several methods, and the effectiveness of each method was determined by calculating compliance 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 parents of these infants, resulting in an overall compliance rate of only 4.8%. Compliance rates varied by method of distribution of the test kits: Houston Women, Infants, and Children (WIC) clinic (53%), volunteers (31%), Rio Grande Valley WIC clinics (14.5%), the patient's private physician (9.9%), and by mail (4.7%). CONCLUSIONS Early detection of neuroblastoma in infants ages 5‐10 months was achieved using ELISA. Compliance rates were poor, but clinics with a preventive health focus, such as the WIC clinics, achieved higher compliance rates than did private physicians. Cancer 1998;82:1593‐602. © 1998 American Cancer Society.