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. Study design: 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 I 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. Conclusion: 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-state neoplasms, and the predictive value of both tests was relatively low. (C) 2005 Mosby, Inc. All rights reserved.