No benefit from screening

Tests of children’s urine for signs of neuroblastoma missed many tumors that later become deadly and detected some cancer that would have disappeared on its own, according to two studies in the April 4 New England Journal of Medicine.

In the first study, researchers led by William G. Woods of Emory University in Atlanta screened about 440,000 newborns in Quebec between 1989 and 1994. The urine tests found signs of the nerve cell cancer about twice as frequently as expected based on medical records of other, unscreened children in North America. However, the death rate from neuroblastoma over the next 9 years was essentially the same.

In the second study, Freimut H. Schilling of Olga Hospital in Stuttgart, Germany and his colleagues screened 1,476,000 year-old children born between 1994 and 1999. They found evidence of neuroblastoma in 149 children, three of whom died of treatment complications during the study. Of the children who initially showed no signs of neuroblastoma, 55 subsequently developed the disease and 14 of these children died.

The screened and unscreened children had similar rates of the most advanced stage of neuroblastoma and similar death rates.

Both research groups say that despite its promise, large-scale cancer screening does not always save lives.