title: Ovarian cancer screening in the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial: findings from the initial screen of a randomized trial.
abstract: 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.
authors.affiliation: Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112-5550, USA. saundra.buys@hsc.utah.edu
authors.forename: Saundra S
authors.initials: SS
authors.lastname: Buys
authors.forename: Edward
authors.initials: E
authors.lastname: Partridge
authors.forename: Mark H
authors.initials: MH
authors.lastname: Greene
authors.forename: Philip C
authors.initials: PC
authors.lastname: Prorok
authors.forename: Douglas
authors.initials: D
authors.lastname: Reding
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Riley
authors.forename: Patricia
authors.initials: P
authors.lastname: Hartge
authors.forename: Richard M
authors.initials: RM
authors.lastname: Fagerstrom
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Ragard
authors.forename: David
authors.initials: D
authors.lastname: Chia
authors.forename: Grant
authors.initials: G
authors.lastname: Izmirlian
authors.forename: Mona
authors.initials: M
authors.lastname: Fouad
authors.forename: Christine C
authors.initials: CC
authors.lastname: Johnson
authors.forename: John K
authors.initials: JK
authors.lastname: Gohagan
mesh_terms: 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
chemical_list: D018394:CA-125 Antigen