This clinical trial studies whether screening methods used to diagnose cancer of the prostate, lung, colon, rectum, or ovaries can reduce deaths from these cancers. Screening tests may help doctors find cancer cells early and plan better treatment for ovarian cancer. The ovarian cancer screening tests are part of a trial that addresses the screening of four cancer sites, each with their own results record: prostate (NCT00002540), lung (NCT01696968), colorectal (NCT01696981), and ovarian (NCT01696994).
PRIMARY OBJECTIVES: I. To determine whether screening with CA125 and transvaginal ultrasound (TVU) can reduce mortality from ovarian cancer in women aged 55-74 at entry. SECONDARY OBJECTIVES: I. To assess screening variables, other than mortality, for each of the interventions including sensitivity, specificity, and positive predictive value. II. To assess the incidence, stage, and survival of cancer cases. III. To investigate the mortality predictive value of biologic and/or prognostic characterizations of tumor tissue as intermediate endpoints. IV. To conduct biomolecular and genetic research into factors associated with cancer carcinogenesis and promotion, as well as the early detection of these factors. OUTLINE: Participants in the overall PLCO study are stratified by screening center, gender, and age (55-59 vs 60-64 vs 65-69 vs 70-74). Participants are randomized to 1 of 2 arms (control vs screening). ARM I (Control): Participants receive standard medical care. Participants complete a Diet History Questionnaire (DHQ) at baseline. ARM II (Ovarian Screening): Participants undergo blood sample collection for CA125 analysis at baseline annually for 5 years. Serum that is not used in the study will be stored in an NCI biorepository. Participants also undergo an ovarian palpation exam (OVR, discontinued in December 1998) and TVU at baseline and annually for 3 years. A scheduling and tracking procedure is implemented to ensure regular attendance at repeat screens for participants screened negative or for those who are designated suspicious or positive at screening but for whom subsequent diagnostic procedures do not reveal ovarian cancer (follow-up diagnostic procedures are through their own medical care environment). Participants diagnosed with ovarian cancer via a screening test are referred for treatment in accordance with current accepted practice for appropriate stage of disease, patient age, and medical condition; a procedure is provided for contact with qualified medical personnel to insure appropriate therapy. Participants complete a Dietary Questionnaire (DQX) at baseline and DHQ at year 3. An Annual Study Update (ADU) (previously referred to as the Periodic Survey of Health \[PSH\] questionnaire) is mailed to each participant annually for 13 years to identify all prevalent and incident cancers of the ovaries as all deaths that occur among both screened and control subjects during the trial. After completion of screening, participants are followed up for at least 13 years.
National Institutes of Health Clinical Center
Bethesda, Maryland, United States
Ovarian Cancer Deaths (Including Primary Peritoneal and Fallopian Tube Cancers)
Ovarian cancer deaths confirmed in participants by a death review committee if available, otherwise by death certificate.
Time frame: Events through 13 years of follow-up or through December 31, 2009; median follow-up 11.9 years.
Ovarian Cancer Death Rates (Including Primary Peritoneal and Fallopian Tube Cancers)
Ovarian cancer deaths confirmed in participants by a death review committee if available, otherwise by death certificate. Rate is the number of deaths divided by person years of follow-up in the study.
Time frame: Events through 13 years of follow-up or through December 31, 2009; median follow-up 11.9 years.
Deaths From All Causes
Deaths from all causes were compared between the ovarian cancer screening arm and the usual care arm.
Time frame: Events through 13 years of follow-up or through December 31, 2009; median follow-up 11.9 years.
Death Rates From All Causes
Deaths from all causes were compared between the ovarian cancer screening arm and the usual care arm. Rate is the number of deaths divided by person years of follow-up in the study.
Time frame: Events through 13 years of follow-up or through December 31, 2009; median follow-up 11.9 years.
Ovarian Cancer Incidence (Including Primary Peritoneal and Fallopian Tube Cancers)
Ovarian cancer diagnoses confirmed by medical record abstraction.
Time frame: Events through 13 years of follow-up or through December 31, 2009; median follow-up 11.9 years.
Ovarian Cancer Incidence Rates (Including Primary Peritoneal and Fallopian Tube Cancers).
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Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SCREENING
Masking
SINGLE
Enrollment
78,216
Ovarian cancer diagnoses confirmed by medical record abstraction. Incidence rate (cumulative) defined as ovarian cancer diagnoses divided by person years at risk for ovarian cancer.
Time frame: Events through 13 years of follow-up or through December 31, 2009; median follow-up 11.9 years.
Complications of Diagnostic Evaluation (DE) Following a Positive Screening Test
Number of positive screens with complications
Time frame: One year from screening examination
T0 (Baseline) CA-125 Screening Results
Cancer Antigen 125 (CA-125) result.
Time frame: T0 (at study entry)
T0 (Baseline) TVU Screening Results
Transvaginal Ultrasound (TVU) result.
Time frame: T0 (at study entry)
T1 CA-125 Screening Results
Cancer Antigen 125 (CA-125) result.
Time frame: T1 (one year after entry)
T1 TVU Screening Results
Transvaginal Ultrasound (TVU) result.
Time frame: T1 (one year after entry)
T2 CA-125 Screening Results
Cancer Antigen 125 (CA-125) result.
Time frame: T2 (two years after entry)
T2 TVU Screening Results
Transvaginal Ultrasound (TVU) result.
Time frame: T2 (one year after entry)
T3 CA-125 Screening Results
Cancer Antigen 125 (CA-125) result.
Time frame: T3 (three years after entry)
T3 TVU Screening Results
Transvaginal Ultrasound (TVU) result.
Time frame: T3 (three years after entry)
T4 CA-125 Screening Results
Cancer Antigen 125 (CA-125) result.
Time frame: T4 (four years after entry)
T5 CA-125 Screening Results
Cancer Antigen 125 (CA-125) result.
Time frame: T5 (five years after entry)