Ref ID: 139 by F598STH6


									Ref ID: 139.1

Effectiveness of mass-screening program on neuroblastoma mortality in 1995-
2000 birth cohort of Japan: Nationwide Neuroblastoma Mortality Study
                    1                    2                   2                      3                 4              5
Kunihiko Hayashi , Toshiharu Fujita , Kota Katanoda , Tomotaka Sobue , Toshiya Sato , Motoi Nishi ,
Keiko Yamamoto

School of Health Sciences1, Gunma University, Maebashi, Gunma, Japan; National Institute of Public Health 2; National Cancer
Center Research Institute3; Kyoto University4; Health Sciences University of Hokkaido5; Saitama Children\'s Medical Center6

BACKGROUND: In Japan, a nationwide mass-screening program using urinary catecholamine
metabolites tests at the age of 6 months has been performed since 1985. In 2003, the Japan Ministry of
Health, Labour and Welfare decided to suspend the program, because of the lack of sufficient evidence
on its effectiveness. We conducted a nationwide epidemiological study to evaluate the effectiveness of
the program on neuroblastoma mortality.
METHODS: The study cohort was all the children who were born in Japan through 1995 to 2000. The
screened children (participants of the program) and non-screened children (non-participants) were
defined by the program participant lists kept by local governments. Neuroblastoma deaths were identified
by death certificates that were retrieved from the national vital statistics of 1995 to 2001.
RESULTS: The study cohort consisted of 7.16 million children, of which 6.26 million children (87.4%)
were in the screened group and 0.90 million children (12.6%) in the non-screened group. We identified
107 neuroblastoma deaths in the study cohort. Of the 107 deaths, 18 cases died before the age of 6
months and 11 cases were diagnosed by 6 months old (these cases were all non-screened). Therefore,
78 neuroblastoma deaths, 50 deaths in the screened group and 28 deaths in the non-screened group,
were included for statistical analysis. The mortality rates were 3.21 (95%CI: 2.32-4.10) per million person-
years in the screened group and 11.92 (95%CI: 7.51-16.34) per million person-years in the non-screened
group. The rate ratio was 0.269 (95%CI: 0.170-0.428) and the difference of hazard between two groups
was statistically significant.
CONCLUSIONS: The finding suggests the effectiveness of the screening program in terms of mortality
from neuroblastoma.


To top