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raised serum activities of ferritin and neurone specific enolase."1 Whether there is a progression from good to bad features remains controversial , although most of the evidence suggests that these features are constant within a given tumour.'6 EFFECTIVENESS AND FEASIBILITY OF SCREENING This study was set up to assess the feasibility of screening for neuroblastoma. Clearly this is possible and a high compliance rate can be achieved by using health visitors. By drying filter paper a low rate of taking repeat samples should be possible and there is a low false positive rate. The authorities in Japan were convinced of the efficacy of screening so that since 1985 all babies in Japan have been offered screening.6 However, there is as yet no convincing evidence of a fall in the death rate from neuroblastoma in Japan.'7 18 Because screening may detect silent cases of neuroblastoma, which might otherwise have spontaneously regressed, the only way to evaluate screening is a controlled trial comparing large screened and contemporaneously unscreened populations. Such a study is underway in Quebec'3 and another has been proposed for the United Kingdom.'9 Screening at 6 months of age has missed cases of neuroblastoma in this study, in Japan,20 and in Quebec (W G Woods, personal communication). This, together with the undoubted increase in incidence of neuro-blastoma in screened populations as a result of the identification of silent cases calls into question the age at which children should be screened or indeed whether they should be screened at all. The age related mortality characteristics of neuroblastoma suggest that screening at around 15-18 months of age may well reduce the incidence of both false negative cases and silent neuroblastomas but whether this would influence the course of fatal cases requires further investigation. A definitive study of neuroblastoma screening is essential and will probably require one million babies to be screened and a similar number of controls. The results of such studies are awaited with interest before neuroblastoma screening is implemented in many other countries. have been possible without the willing support of the health visitors of all four districts. Advanced neuroblastoma: improved response rate using a multiagent regimen (OPEC). Three years experience with random urinary homovanillic acid and vanillylmandelic acid levels in the diagnosis of neuroblastoma.