This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Barrette, S. Articles by Woods, W. G. Search for Related Content PubMed PubMed Citation Articles by Barrette, S. Articles by Woods, W. G. Social Bookmarking                            What's this?

Incidence of Neuroblastoma After a Screening Program

Stéphane Barrette, Mark L. Bernstein, Leslie L. Robison, Yvan Samson, Josée Brossard, Sheila Weitzman, William G. Woods

From the Hôpital Ste-Justine, Montréal; Centre Hospitalier de l'Université Laval, Ste-Foy; Centre Hospitalier Universitaire de Sherbrooke, Quebec; IWK Health Center, Halifax, Nova Scotia; Hospital for Sick Children, Toronto, Ontario, Canada; St Jude Children's Research Hospital, Memphis, TN; and AFLAC Cancer Center, Emory University and Children's Healthcare of Atlanta, Atlanta, GA

Address reprint requests to Stéphane Barrette, 3175 Côte Ste-Catherine, bureau 3415, Montréal, Quebec, Canada, H3T 1C5; e-mail: stephane.barrette{at}umontreal.ca

Purpose A significant increase in the incidence of neuroblastoma occurred among a 5-year birth cohort (May 1989 to April 1994) during an active urinary screening program for its early detection. We examined the postscreening incidence of neuroblastoma in the subsequent 5-year birth cohort (May 1994 to April 1999), with follow-up to 2002, to determine whether the incidence remained increased.

Patients and Methods We reviewed institutional records of patients diagnosed with neuroblastoma during the period from 1994 to 2002 who were born in 1994 to 1999 in the province of Quebec, as well as in the state of Minnesota and the province of Ontario, regions that had served as controls during the screening interval. We calculated and compared incidence rates during the 1994 to 2002 time period.

Results For the 5-year birth cohort as a whole, the rate of newly diagnosed neuroblastoma was higher in Quebec than in the control populations of Minnesota and Ontario (standardized incidence ratio, 1.34; 95% CI, 1.03 to 1.70). However, in years 4 and 5 of the interval, population-based incidence declined to the same levels as those seen in the control areas.

Conclusion The institution of a urinary screening program for neuroblastoma led to increased awareness of the diagnosis and an elevated rate of diagnosis even after the completion of the screening evaluation. However, this halo effect was transient, with diagnostic rates subsequently decreasing within the range seen in control populations.

Supported by Grant No. CA46907) from the National Institutes of Health.

Authors’ disclosures of potential conflicts of interest and author contributions are found at the end of this article.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Facebook    Reddit    Technorati    Twitter    What's this?