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document
Potential effect of the risk of ovarian cancer algorithm ( ROCA ) on the mortality outcome of the Prostate , Lung , Colorectal and Ovarian ( PLCO ) trial . Recently , the Prostate , Lung , Colorectal and Ovarian ( PLCO ) Trial reported no mortality benefit for annual screening with CA-125 and transvaginal ultrasound ( TVU ) . Currently ongoing is the UK Collaborative Trial of Ovarian Cancer Screening ( UKCTOCS ) , which utilizes the risk of ovarian cancer algorithm ( ROCA ) , a statistical tool that considers current and past CA125 values to determine ovarian cancer risk . In contrast , PLCO used a single cutoff for CA125 , based on current levels alone . We investigated whether having had used ROCA in PLCO could have , under optimal assumptions , resulted in a significant mortality benefit by applying ROCA to PLCO CA125 screening values . A best-case scenario assumed that all cancers showing a positive screen result earlier with ROCA than under the PLCO protocol would have avoided mortality ; under a stage-shift scenario , such women were assigned survival equivalent to Stage I/II screen-detected cases . Updated PLCO data show 132 intervention arm ovarian cancer deaths versus 119 in usual care ( relative risk , RR = 1.11 ) . Forty-three ovarian cancer cases , 25 fatal , would have been detected earlier with ROCA , with a median ( minimum ) advance time for fatal cases of 344 ( 147 ) days . Best-case and stage-shift scenarios gave 25 and 19 deaths prevented with ROCA , for RRs of 0.90 ( 95 % CI : 0.69-1.17 ) and 0.95 ( 95 % CI : 0.74-1.23 ) , respectively . Having utilized ROCA in PLCO would not have led to a significant mortality benefit of screening . However , ROCA could still show a significant effect in other screening trials , including UKCTOCS .
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Intervention_Other
ovarian cancer algorithm ( ROCA )
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Intervention_Other
ovarian cancer algorithm ( ROCA )
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Intervention_Other
ROCA in PLCO
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Intervention_Other
ROCA
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Intervention_Other
ROCA
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Intervention_Other
ROCA
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Intervention_Other
ROCA
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Outcome_Mortality
mortality outcome
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Outcome_Mortality
significant mortality benefit
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Outcome_Mortality
mortality
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Outcome_Mortality
fatal cases
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Outcome_Mortality
deaths
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Outcome_Mortality
mortality benefit
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Participant_Condition
all cancers showing a positive screen result earlier with ROCA than under the PLCO