Some neuroblastomas can be found early, before they start to cause any signs or symptoms.
For example, a small number of neuroblastomas are found before birth during an ultrasound, a test that uses sound waves to create an image of the internal organs of a fetus. Ultrasounds are often done during pregnancy to estimate the age of a fetus, predict the date of birth, and look for certain common birth defects.
Neuroblastoma is also sometimes found incidentally in young children without any symptoms during tests done to look for other childhood diseases or during regular medical checkups.
But most often, neuroblastoma is first detected because of signs or symptoms a child is having.
Screening for neuroblastoma
Screening is testing for a disease, such as cancer, in people who don’t have any symptoms. Screening can help find some types of cancer early, when they’re likely to be easier to treat.
Studies in several countries have looked at screening infants for neuroblastoma. Screening was done by testing the infants’ urine for certain chemicals made by neuroblastoma tumors. (For more on this urine test, see Tests for Neuroblastoma.) However, these studies did not find neuroblastoma screening to be helpful.
Screening did find many tumors that wouldn’t normally have been detected. But most of these tumors probably would have gone away or matured into benign (non-cancerous) tumors on their own, so they never would have caused any problems if they hadn’t been found. (See What Is Neuroblastoma? for more on this.) Screening didn’t lower the number of cancers found at advanced stages, nor did it lower the number of deaths from neuroblastoma.
Screening for neuroblastoma could have downsides as well. For example, finding tumors that would never cause serious problems might still needlessly frighten parents and lead to unnecessary tests and surgery in some children.
For these reasons, most experts do not recommend screening for neuroblastoma in infants who are not at increased risk of the disease.
Screening might be recommended for infants who are at increased risk, such as those with a family history of neuroblastoma. Along with a urine test, this might also include genetic testing to look for changes in the ALK gene, which is often seen in cases of hereditary (familial) neuroblastoma.