title: Pathologic findings following false-positive screening tests for ovarian cancer in the Prostate, Lung, Colorectal and Ovarian (PLCO) cancer screening trial.
abstract: OBJECTIVE
  In the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial (PLCO), ovarian cancer screening with transvaginal ultrasound (TVU) and CA-125 produced a large number of false-positive tests. We examined relationships between histopathologic diagnoses, false-positive test group, and participant and screening test characteristics.
  
  
  METHODS
  The PLCO ovarian cancer screening arm included 39,105 women aged 55-74 years assigned to annual CA-125 and TVU. Histopathologic diagnoses from women with false-positive tests and subsequent surgery were reviewed in this analysis: all CA125+ (n=121); all CA125+/TVU+ (n=46); and a random sample of TVU+ (n=373). Demographic and ovarian cancer risk factor data were self-reported. Pathologic diagnoses were abstracted from surgical pathology reports. We compared participant characteristics and pathologic diagnoses by category of false-positive using Pearson χ2, Fisher's exact, or Wilcoxon-Mann-Whitney tests.
  
  
  RESULTS
  Women with a false-positive TVU were younger (P<0.001), heavier (P<0.001), and reported a higher frequency of prior hysterectomy (P<0.001). Serous cystadenoma, the most common benign ovarian diagnosis, was more frequent among women with TVU+ compared to CA-125+ and CA-125+/TVU+ (P<0.001). Benign non-ovarian findings were commonly associated with all false-positives, although more frequently with CA-125+ than TVU+ or CA-125+/TVU+ groups (P=0.019). Non-ovarian cancers were diagnosed most frequently among CA-125+ (P<0.001).
  
  
  CONCLUSIONS
  False-positive ovarian cancer screening tests were associated with a range of histopathologic diagnoses, some of which may be related to patient and screening test characteristics. Further research into the predictors of false-positive ovarian cancer screening tests may aid efforts to reduce false-positive results.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 6120 Executive Blvd., Rockville, MD 20852, USA. sarah.nyante@nih.gov
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Nyante
authors.forename: Amanda
authors.initials: A
authors.lastname: Black
authors.forename: Aimée R
authors.initials: AR
authors.lastname: Kreimer
authors.forename: Máire A
authors.initials: MA
authors.lastname: Duggan
authors.forename: J Daniel
authors.initials: JD
authors.lastname: Carreon
authors.forename: Bruce
authors.initials: B
authors.lastname: Kessel
authors.forename: Saundra S
authors.initials: SS
authors.lastname: Buys
authors.forename: Lawrence R
authors.initials: LR
authors.lastname: Ragard
authors.forename: Karen A
authors.initials: KA
authors.lastname: Johnson
authors.forename: Barbara K
authors.initials: BK
authors.lastname: Dunn
authors.forename: Lois
authors.initials: L
authors.lastname: Lamerato
authors.forename: John M
authors.initials: JM
authors.lastname: Commins
authors.forename: Christine D
authors.initials: CD
authors.lastname: Berg
authors.forename: Mark E
authors.initials: ME
authors.lastname: Sherman
mesh_terms: D000368:Aged; D018394:CA-125 Antigen / Q000097:blood; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography; D014621:Vagina / Q000000981:diagnostic imaging
chemical_list: D018394:CA-125 Antigen