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Neuroblastoma Screening (PDQ®): Screening - Health Professional Information [NCI] - Summary of Evidence

Note: Separate PDQ summaries on Neuroblastoma Treatment and Levels of Evidence for Cancer Screening and Prevention Studies are also available.

Intervention

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Screening, usually at age 6 months, for urine vanillylmandelic acid and homovanillic acid, which are metabolites of the hormones norepinephrine and dopamine.

Benefits

Based on solid evidence, screening for neuroblastoma does not lead to decreased mortality.

Description of the Evidence

  • Study Design: Evidence obtained from nonrandomized controlled trials.
  • Internal Validity: Good.
  • Consistency: Good.
  • Magnitude of Effects on Health Outcomes: No effect on mortality.
  • External Validity: Fair.

Harms

Based on solid evidence, screening infants for neuroblastoma leads to an increase in incidence of early-stage neuroblastoma. There is no concurrent decrease in incidence in screened children of advanced-stage disease, which typically does poorly, or of incidence in children older than 1 year. The cases identified by screening almost exclusively have biologically favorable properties.

Based on solid evidence, screening infants for neuroblastoma results in overdiagnosis (diagnosis of some neuroblastomas detectable by mass screening that would not have been clinically diagnosed later). This leads to unnecessary diagnostic and therapeutic procedures with consequent physical and psychological morbidity, including death from treatment complications.

Description of the Evidence

  • Study Design: Evidence obtained from nonrandomized controlled trials.
  • Internal Validity: Good.
  • Consistency: Good.
  • Magnitude of Effects on Health Outcomes: No effect on mortality. Screening may overdiagnose as many as seven cases per 100,000 infants screened.
  • External Validity: Fair.

    This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http:// cancer .gov or call 1-800-4-CANCER.

    WebMD Public Information from the National Cancer Institute

    Last Updated: September 04, 2014
    This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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