Universität zu Köln

Berthold, Frank ORCID: 0000-0002-7613-1723, Spix, Claudia, Erttmann, Rudolf, Hero, Barbara, Michaelis, Joerg, Treuner, Joern, Ernst, Angela and Schilling, Freimut H. (2021). Neuroblastoma Screening at 1 Year of Age: The Final Results of a Controlled Trial. JNCI Cancer Spectr., 5 (4). OXFORD: OXFORD UNIV PRESS. ISSN 2515-5091

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Abstract

Background: Neuroblastoma screening aims to reduce neuroblastoma-related mortality. A controlled trial showed no reduction in stage 4 disease incidence and preliminary mortality data. This article presents epidemiologic and clinical data 20 years after cessation of the screening program. Methods: The patients with detected disease in the screening area were compared with the clinically diagnosed patients in the control area and in the prestudy and poststudy cohorts. All statistical tests were 2-sided. Results: The cumulative incidence for children aged 1 to 6 years in the birth study cohorts (1994-1999) in the screening arm was 13.4 cases per 100 000 births (95% confidence interval [CI] = 12.2 to 14.6) based on 61.2% of screening participants and 38.8% of nonparticipants. Screening participants had a cumulative incidence of 15.7 (95% CI = 14.0 to 17.4) per 100 000 births. The cumulative incidence in the contemporary control cohort was 9.3 (95% CI = 8.2 to 10.3) per 100 000 births, 7.6 (95% CI = 6.8 to 8.4) in the prestudy cohort, and 8.1 (95% CI = 7.4 to 8.9) in the poststudy cohort from 2000 to 2004 (P<.001 each). The increased incidence in the screening cohort was restricted to stages 1 through 3, while stage 4 incidence was not reduced. The cumulative mortality for deaths within 10 years from diagnosis and per 100 000 births remained unchanged. Patients with stage 4 disease detected by screening had better biological characteristics and an improved outcome compared with those stage 4 cases not detected by screening. Conclusions: Neuroblastoma screening at 1 year of age reduced neither stage 4 incidence nor neuroblastoma mortality and was affected by overdiagnosis, leading to unnecessary treatment. A few screening-detected stage 4 cases represent a biologically interesting subgroup but do not change the recommendation to close the catecholamine-based neuroblastoma screening book.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Berthold, Frank UNSPECIFIED orcid.org/0000-0002-7613-1723 UNSPECIFIED Spix, Claudia UNSPECIFIED UNSPECIFIED UNSPECIFIED Erttmann, Rudolf UNSPECIFIED UNSPECIFIED UNSPECIFIED Hero, Barbara UNSPECIFIED UNSPECIFIED UNSPECIFIED Michaelis, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Treuner, Joern UNSPECIFIED UNSPECIFIED UNSPECIFIED Ernst, Angela UNSPECIFIED UNSPECIFIED UNSPECIFIED Schilling, Freimut H. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-591737
DOI:	10.1093/jncics/pkab041
Journal or Publication Title:	JNCI Cancer Spectr.
Volume:	5
Number:	4
Date:	2021
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	2515-5091
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language SPONTANEOUS REGRESSION; MORTALITY; PROGRAM; INFANTS; JAPAN Multiple languages Oncology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/59173