{"corpus_id":13772210,"paper_sha":"53d111cddf54c8dc91b2b7ca799cc3ae07d33fb4","doi":"10.1001/jama.2011.766","arxiv_id":null,"pmid":21642681,"pmcid":null,"mag_id":2128104740,"dblp_id":null,"acl_id":null,"title":"Effect of screening on ovarian cancer mortality: the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Randomized Controlled Trial.","year":2011,"publication_date":"2011-06-08","venue":"Journal of the American Medical Association (JAMA)","journal":{"name":"JAMA","pages":"\n          2295-303\n        ","volume":"305 22"},"journal_issn":null,"journal_title":null,"publication_types":["Study","JournalArticle"],"pubmed_pub_types":["Journal Article","Multicenter Study","Randomized Controlled Trial","Research Support, N.I.H., Extramural","Research Support, N.I.H., Intramural"],"s2_fields_of_study":["Medicine"],"reference_count":23,"citation_count":1205,"influential_citation_count":45,"is_open_access":false,"arxiv_categories":null,"arxiv_license":null,"arxiv_journal_ref":null,"mesh_headings":[{"d":"Aged","mj":false,"ui":"D000368"},{"d":"CA-125 Antigen","mj":false,"qs":[{"q":"blood","mj":true,"ui":"Q000097"}],"ui":"D018394"},{"d":"Cause of Death","mj":false,"ui":"D002423"},{"d":"False Positive Reactions","mj":false,"ui":"D005189"},{"d":"Female","mj":false,"ui":"D005260"},{"d":"Humans","mj":false,"ui":"D006801"},{"d":"Mass Screening","mj":false,"qs":[{"q":"methods","mj":true,"ui":"Q000379"}],"ui":"D008403"},{"d":"Middle Aged","mj":false,"ui":"D008875"},{"d":"Ovarian Neoplasms","mj":false,"qs":[{"q":"blood","mj":false,"ui":"Q000097"},{"q":"diagnostic imaging","mj":true,"ui":"Q000000981"},{"q":"mortality","mj":true,"ui":"Q000401"},{"q":"surgery","mj":false,"ui":"Q000601"}],"ui":"D010051"},{"d":"Ovariectomy","mj":false,"qs":[{"q":"adverse effects","mj":false,"ui":"Q000009"}],"ui":"D010052"},{"d":"Ultrasonography","mj":false,"qs":[{"q":"adverse effects","mj":false,"ui":"Q000009"}],"ui":"D014463"},{"d":"United States","mj":false,"qs":[{"q":"epidemiology","mj":false,"ui":"Q000453"}],"ui":"D014481"},{"d":"Vagina","mj":false,"qs":[{"q":"diagnostic imaging","mj":false,"ui":"Q000000981"}],"ui":"D014621"}],"chemicals":[{"n":"CA-125 Antigen","ui":"D018394","reg":"0"}],"comments_corrections":null,"source_flags":5,"s2_open_access_pdf_url":null,"s2_open_access_landing_url":null,"s2_open_access_license":null,"s2_open_access_status":null,"pmc_open_access_pdf_url":null,"pmc_open_access_landing_url":null,"pmc_open_access_license":null,"pmc_open_access_status":null,"unpaywall_open_access_pdf_url":null,"unpaywall_open_access_landing_url":null,"unpaywall_open_access_license":null,"unpaywall_open_access_status":null,"abstract":"CONTEXT: Screening for ovarian cancer with cancer antigen 125 (CA-125) and transvaginal ultrasound has an unknown effect on mortality. OBJECTIVE: To evaluate the effect of screening for ovarian cancer on mortality in the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial. DESIGN, SETTING, AND PARTICIPANTS: Randomized controlled trial of 78,216 women aged 55 to 74 years assigned to undergo either annual screening (n = 39,105) or usual care (n = 39,111) at 10 screening centers across the United States between November 1993 and July 2001. Intervention The intervention group was offered annual screening with CA-125 for 6 years and transvaginal ultrasound for 4 years. Participants and their health care practitioners received the screening test results and managed evaluation of abnormal results. The usual care group was not offered annual screening with CA-125 for 6 years or transvaginal ultrasound but received their usual medical care. Participants were followed up for a maximum of 13 years (median [range], 12.4 years [10.9-13.0 years]) for cancer diagnoses and death until February 28, 2010. MAIN OUTCOME MEASURES: Mortality from ovarian cancer, including primary peritoneal and fallopian tube cancers. Secondary outcomes included ovarian cancer incidence and complications associated with screening examinations and diagnostic procedures. RESULTS: Ovarian cancer was diagnosed in 212 women (5.7 per 10,000 person-years) in the intervention group and 176 (4.7 per 10,000 person-years) in the usual care group (rate ratio [RR], 1.21; 95% confidence interval [CI], 0.99-1.48). There were 118 deaths caused by ovarian cancer (3.1 per 10,000 person-years) in the intervention group and 100 deaths (2.6 per 10,000 person-years) in the usual care group (mortality RR, 1.18; 95% CI, 0.82-1.71). Of 3285 women with false-positive results, 1080 underwent surgical follow-up; of whom, 163 women experienced at least 1 serious complication (15%). There were 2924 deaths due to other causes (excluding ovarian, colorectal, and lung cancer) (76.6 per 10,000 person-years) in the intervention group and 2914 deaths (76.2 per 10,000 person-years) in the usual care group (RR, 1.01; 95% CI, 0.96-1.06). CONCLUSIONS: Among women in the general US population, simultaneous screening with CA-125 and transvaginal ultrasound compared with usual care did not reduce ovarian cancer mortality. Diagnostic evaluation following a false-positive screening test result was associated with complications. Trial Registration clinicaltrials.gov Identifier: NCT00002540.","claims":[{"public_id":"cl_cb4bf08872020520c6d85ca26049ae10","status":"active","text":"False-positive screening results led to surgical follow-up in many women, and 15% of those who underwent surgery experienced at least one serious complication.","confidence":0.97,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous (12632b8b5f)","roles":["extraction"],"url":"https://sah.borca.ai/u/12632b8b5f"}],"url":"https://sah.borca.ai/claims/cl_cb4bf08872020520c6d85ca26049ae10"},{"public_id":"cl_7f8d113c97275ad5db0b02a97d8cc33b","status":"active","text":"Ovarian cancer incidence was higher in the screening group than in the usual care group, with a rate ratio of 1.21 (95% CI, 0.99-1.48).","confidence":0.94,"contributors":[{"id":1,"public_id":"12632b8b5f","public_label":"Anonymous 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