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Barrette S, Bernstein ML, Robison LL, Samson Y, Brossard J, Weitzman S, Woods WG. Incidence of Neuroblastoma After a Screening Program. J Clin Oncol 2007; 25:4929-32. [DOI: 10.1200/jco.2007.12.1905] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
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.
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Affiliation(s)
- Stéphane Barrette
- 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
| | - Mark L. Bernstein
- 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
| | - Leslie L. Robison
- 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
| | - Yvan Samson
- 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
| | - Josée Brossard
- 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
| | - Sheila Weitzman
- 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
| | - 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
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