April 4, 2002 BOSTON (AP) -- Using a urine test to screen babies for a relatively common childhood tumor can spot the cancers early but fails to save lives, a new study finds.
The test screens for a form of cancer called neuroblastoma that occurs in the adrenal glands and the sympathetic nervous system. The tumors usually develop before age 4 and can be fatal.
Researchers in Germany and Canada tested large numbers of babies. While the test found some cancers, they also missed some and overall did not reduce the number of deaths from neuroblastoma, the researchers said.
An international conference in 1998 recommended against routinely screening babies for neuroblastoma, and the test is not widely used.
Results of the two studies were published in Thursday's issue of the New England Journal of Medicine. The Canadian study was directed by Dr. William G. Woods of Emory University and the German one by Dr. Freimut H. Schilling of Olga Hospital in Stuttgart.
The researchers theorize that there are two varieties of neuroblastoma. One often spreads and kills while the other frequently goes away by itself. Apparently, the test typically finds the less dangerous of the two forms.
The researchers say the screening may actually do more harm then good by diagnosing tumors that are destined to disappear. The discovery could result in children receiving dangerous but unnecessary cancer treatment.
The situation is far different from screening for adult malignancies, such as mammograms to detect breast cancer, because those tumors typically do not go away.
In an accompanying editorial, Dr. George Cunningham of the California state health department said the latest studies demonstrate that new childhood screening tests should not be used until they are proven to save lives or improve the quality of life.
In the Canadian study, doctors screened all 476,654 babies born in Quebec from 1989 to 1994. The test found 43 cases of neuroblastoma. All of the babies survived, although two suffered severe side effects from cancer treatment.
However, 22 others whose cancers were missed died of the disease, and the overall death rate was no different from the rate in several other parts of Canada and the United States where no screening was done.
Results were similar in the other study, conducted on 1.5 million babies in six German states from 1995 to 2000. During the follow up, there were 1.3 deaths from neuroblastoma per 100,000 children in the places screened, compared with 1.2 deaths per 100,000 in other areas.
The urine test checks for substances called catecholamines that are made by neuroblastomas.
Copyright 2002 The Associated Press. All rights reserved.
