Screening with CA-125 and transvaginal ultrasound (TVU) did not reduce ovarian cancer mortality after 15 years median follow-up, according to a recent study. Participants in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial were randomized from 1993 to 2001 at 10 US centers to an intervention arm (n=39,105) or usual care arm (n=39,111). Intervention arm women were screened for ovarian cancer with annual TVU (4 years) and CA-125 (6 years), with a fixed cutoff at 35 U/mL for CA-125. Median follow-up was 14.7 years in each arm and maximum follow-up 19.2 years. Researchers found:
• There were 187 (intervention) and 176 (usual care) deaths from ovarian cancer (RR, 1.06).
• Risk ratios were similar for study years 0 to 7(RR, 1.06) and 14+ (RR, 1.09).
• All-cause mortality has a risk ratio of 1.01.
• Ovarian cancer specific survival was not significantly different across trial arms.
Pinsky PF, Yu K, Kramer BS, et al. Extended mortality results for ovarian cancer screening in the PLCO trial with median 15 years follow-up. [Published online ahead of print September 9, 2016]. Gynecol Oncol. doi:10.1016/j.ygyno.2016.08.334.