Extended mortality results for ovarian cancer screening in the PLCO trial with median 15 years follow-up
Open accessAbstract
Background The Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial originally reported no mortality benefit of ovarian cancer screening after a median of 12.4years of follow-up. The UKCTOCS screening trial failed to show a statistically significant mortality reduction in the primary analysis but reported an apparent increased mortality benefit in trial years 7-14 compared to 0-7. Here we report an updated analysis of PLCO with extended mortality follow-up.Methods Participants were randomized from 1993 to 2001 at ten U.S. centers to an intervention or usual care arm. Intervention arm women were screened for ovarian cancer with annual trans-vaginal ultrasound (TVU) (4years) and CA-125 (6years), with a fixed cutoff at 35U/mL for CA-125. The original follow-up period was for up to 13years (median follow-up 12.4years); in this analysis follow-up for mortality was extended by up to 6years.Results 39,105 (intervention) and 39,111 (usual care) women were randomized, of which 34,253 and 34,304, respectively, had at least one ovary at baseline. Median follow-up was 14.7years in each arm and maximum follow-up 19.2years in each arm. A total of 187 (intervention) and 176 (usual care) deaths from ovarian cancer were observed, for a risk-ratio of 1.06 (95% CI: 0.87-1.30). Risk-ratios were similar for study years 0-7 (RR=1.04), 7-14 (RR=1.06) and 14+ (RR=1.09). The risk ratio for all-cause mortality was 1.01 (95% CI: 0.97-1.05). Ovarian cancer specific survival was not significantly different across trial arms (p=0.16).Conclusion Extended follow-up of PLCO indicated no mortality benefit from screening for ovarian cancer with CA-125 and TVU.
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Serum biomarkers are often insufficiently sensitive or specific to facilitate cancer screening or diagnostic testing.
“Serum biomarkers are often insufficiently sensitive or specific to facilitate cancer screening or diagnostic testing.”
From Detection of ovarian cancer via the spectral fingerprinting of quantum-defect-modified carbon nanotubes in serum by machine learning (2022) · cites this paper as [8]
Stand-alone serum biomarker measurements have proven of little survival benefit due to limited specificity and low positive predictive value.
“However, stand-alone biomarker measurements have proven of little survival benefit due to limited specificity and low positive predictive value (PPV)7,8.”
From Detection of ovarian cancer via the spectral fingerprinting of quantum-defect-modified carbon nanotubes in serum by machine learning (2022) · cites this paper as [8]
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- Authors
- Pinsky, P. F., Yu, K., Kramer, B. S., Black, A., Buys, S. S., Partridge, E., Gohagan, J., Berg, C. D., & Prorok, P. C.
- Affiliations
- National Institutes of Health (US)
- University of Utah (US)
- University of Alabama at Birmingham (US)
- Corresponding author
- Pinsky, Paul F.
- ORCID
- Venue
- Gynecologic Oncology
- Publisher
- Elsevier BV
- Published
- 2016-11
- Volume
- 143
- Issue
- 2
- Pages
- 270-275
- ISSN
- 0090-8258 (ISSN-L)
- PMC
- PMC5077651
- OpenAlex
- W2520894980
- Cited by
- 191
- References
- 13
- Citations by year
- 2026: 14 · 2025: 15 · 2024: 46 · 2023: 11 · 2022: 19 · 2021: 18 · 2020: 19 · 2019: 16 · 2018: 20 · 2017: 9 · 2016: 4
- FWCI
- 21.71
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Gynecologic Oncology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (Z99 CA999999)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › BRCA gene mutations in cancer
- Keywords
- ovarian cancer screening, PLCO Cancer Screening Trial, CA125, transvaginal ultrasound, all-cause mortality, long-term follow-up
- MeSH terms
- Aged, Female, Follow-Up Studies, Humans, Middle Aged, Ovarian Neoplasms, Ultrasonography, Vagina, CA-125 Antigen, Early Detection of Cancer
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