Ovarian cancer screening in the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial: findings from the initial screen of a randomized trial.
OBJECTIVE
Ovarian cancer screening with transvaginal ultrasound (TVU) and CA-125 was evaluated in the Prostate, Lung, Colorectal and Ovarian (PLCO) Trial.


METHODS
This was a randomized controlled trial of screening versus usual care. Baseline screening results are reported.


RESULTS
Of 39,115 women randomized to receive screening, 28,816 received at least 1 test. Abnormal TVU was found in 1338 (4.7%), and abnormal CA-125 in 402 (1.4%). Twenty-nine neoplasms were identified (26 ovarian, 2 fallopian, and 1 primary peritoneal neoplasm). Nine were tumors of low malignant potential and 20 were invasive. The positive predictive value for invasive cancer was 3.7% for an abnormal CA-125, 1.0% for an abnormal TVU, and 23.5% if both tests were abnormal.


CONCLUSIONS
The effect of screening on ovarian cancer mortality in the PLCO cohort has yet to be evaluated and will require longer follow-up. Screening identified both early- and late-stage neoplasms, and the predictive value of both tests was relatively low.
Buys
Saundra S
SS
Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112-5550, USA. saundra.buys@hsc.utah.edu
Partridge
Edward
E
Greene
Mark H
MH
Prorok
Philip C
PC
Reding
Douglas
D
Riley
Thomas L
TL
Hartge
Patricia
P
Fagerstrom
Richard M
RM
Ragard
Lawrence R
LR
Chia
David
D
Izmirlian
Grant
G
Fouad
Mona
M
Johnson
Christine C
CC
Gohagan
John K
JK
D000368:Aged; D018394:CA-125 Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging*; D011237:Predictive Value of Tests; D016032:Randomized Controlled Trials as Topic; D014463:Ultrasonography
D018394:CA-125 Antigen