LANDMARK TRIAL - PLCO Flashcards
PLCO Trial name
the effect of screening on ovarian cancer mortality - prostate lung colorectal and ovarian cancer screening randomised control trial
What was the aim of the PLCO study?
to assess the effect of screening on ovarian cancer mortality
what was the study design of the PLCO study?
RCT
non blinded
70+000 women
aged between 55 and 74
What was the intervention?
- intervention group had 4 years of TV USS and 6 yrs of Ca 125 screening
vs routine care
what was the inclusion criteria for the PLCO study?
- 55 -74 y/o age women
- no h/o oophorectomy
- no h/o LCO cancers
What was the exclusion criteria?
- tamoxifen therapy
- h/o LCO cancers
- h/o oophorectomy
what was the primary outcome assessed?
- ovarian cancer specific mortality
what were the secondary outcomes assessed?
- ovarian cancer incidence
- staging
- survival
- harms of screening
- all cause mortality
what were the results with regard primary and secondary outcomes?
- no significant difference in ovarian cancer specific mortality
- similar staging and survival rates among both groups
- 15% of women who had a false +ve result had a surgical complication
- higher rate of oophorectomy in those with false +ve result
How would you summarise the PLCO findings?
- screening for ovarian cancer using Ca125 and USS did not impact on ovarian cancer specific mortality
- nor did it have a S.S impact on incidence, staging of ovarian cancer
- It did however result in morbidity associated with further investigation of false +ve results - 15% of women with false +ve result sustained a surgical complication from the investigation of result
what were the strengths of the study
large
RCT
similar baseline characteristics between groups
good compliance within the intervention groups
what were the limitations of this study?
- homogenous mainly white women studied
- inadequate treatment data collected - did not comment on systemic therapy or type of surgeon, both of which impact on outcome
